(Twinrix x 2) x 3 = (0.95) HBsAb+

I recently had a dentist referred to me for treatment of an infection and in reviewing her chart incidentally noted that her hepatitis B surface antibody was negative. In taking her history I learned that after receiving the hepatitis B vaccine series twice (6 doses), she still had a negative hepatitis B surface antibody, which indicates no protection against hepatitis B, a major occupational hazard for dentists.

To the rescue is this important study (full text here). In this study, 48 hepatitis B vaccine nonresponders were given double doses of Twinrix vaccine (combined hepatitis A + hepatitis B vaccine) at 0, 1 and 6 months. At the end of that vaccine series, 95% of the nonresponders developed protective levels of antibody against hepatitis B. This is a very cool finding for healthcare workers who are hepatitis B vaccine nonresponders.

The study isn't new. Dan reviewed it for Journal Watch several years ago (full text here), but I wasn't aware of it and neither were my partners, so I thought it would be important to highlight this paper.