The hepatitis B vaccine can reduce your risk of developing the infection. But up to 10% of people may not respond to this vaccine. They may need to take extra steps to avoid hep B exposure.

The hepatitis B vaccine is one of the best ways to reduce your risk of a hepatitis infection, but an estimated 5–10% of people who receive the vaccine are “non-responders.”

A hepatitis B non-responder is someone who doesn’t develop protective antibodies after receiving the hepatitis vaccine.

To be classed a non-responder, you must have received at least two full doses of the vaccine without developing antibodies and been tested to make sure you don’t have a chronic or acute hepatitis B infection.

This article will explain more about how someone develops a non-response to the hepatitis B vaccine, what that means, and how you can reduce their risk of developing this type of infection.

Hepatitis B (hep B) is an infection and inflammation of the liver. It’s typically spread through contact with bodily fluids.

Acute hepatitis B is curable and sometimes resolves on its own without medications. Chronic hepatitis B can’t be cured, but medications can help slow down the damage to your liver. Sometimes people with chronic hepatitis B develop liver failure and require liver transplants.

Not everyone with hep B experiences symptoms. When symptoms do occur, they typically include:

Why do hep B antibodies matter in avoiding this infection?

When it comes to developing a natural response to hep B, antibodies are important.

Antibodies are blood proteins produced by your immune system. Reactive antibodies are antibodies that react to the presence of an infection by activating your immune system.

People develop antibodies by having the infection or through a vaccine. Creating reactive antibodies that will help your immune system recognize and fight off the infection is the goal of vaccines.

However, if you don’t respond to the vaccines, you may be more at risk for developing hep B.

There’s not a single clear answer for what causes people to be non-responders.

However, there are some key risk factors:

  • having obesity
  • smoking
  • already having a chronic illness that compromises the immune system
  • being older

There are a few steps to take if you don’t respond to the hepatitis B vaccination.

  1. Testing: The first step is receiving a test for the hep B virus. People who have contracted the virus won’t respond to the vaccine, and it’s possible to have hepatitis without having any symptoms. This means that not reacting to a hep B vaccination is sometimes the first indication that you have the infection, and it’s why testing is such an important first step.
  2. Another vaccine: If you’re found to not have hep B, the next step is often receiving an additional vaccine. Someone who’s non-responsive after a single three-dose vaccination has a 30–50% chance of responding to a second three-dose vaccination. People receiving this second round of vaccination will be tested again about a month after receiving the final dose in the three-dose series. If you still have no reactive antibodies at this point, you’re considered a non-responder.
  3. Support: Hep B non-responders can receive counseling and education about how to reduce their own chances of hep B and how to lessen the chances of passing a hep B infection to others.

Hep B non-responders will typically be advised to:

A person who is a hep B non-responder can hold any role in a healthcare setting, including nursing roles.

The U.S. Occupational Safety and Health Administration (OSHA) requires that all employees whose job requires exposure to blood are offered the hepatitis B vaccination and that personal protective equipment, such as gloves, is always available.

There’s no regulation preventing people who can’t receive the vaccine, who are vaccine non-responders, or who have chronic hep B infections from holding these positions.

Individual healthcare facilities and organizations are able to set their own policies about vaccination status. This means that some healthcare facilities might not employ nurses who are hep B non-responders or might have extra requirements for non-responders.

However, these individual policies don’t affect a non-responder’s overall ability to hold a nursing license or gain employment.

Hepatitis B is an infection that affects your liver and that can lead to liver damage. The hep B vaccine is one of the most effective ways to prevent hep B, but not everyone responds to the vaccine. People who don’t produce protective antibodies to fight hepatitis B after two rounds of vaccinations are called non-responders.

Hep B non-responders will be advised to be cautious and take steps to reduce their risk of hep B, such as using barrier methods during sex and avoiding contact with the bodily fluids of others.