Ask the Experts: Hepatitis B Infection Diagnosed After Vaccination

Welcome to Immunize.org’s Ask the Experts resources. This Ask the Experts question is presented by Immunize.org’s Kelly L. Moore, MD, MPH.
Question: A healthy young adult patient who received the HepB vaccine series before college recently had a triple panel screen for hepatitis B virus infection and discovered that he had chronic hepatitis B. Did the vaccine fail? What do I tell the patient?
Answer: While breakthrough infections can happen, it is very uncommon in an otherwise healthy young adult. In this scenario, it is unknown when the HBV infection occurred. It is possible that the person had an unrecognized exposure to hepatitis B virus at some time before they were vaccinated: they may even have been born to a hepatitis B-infected mother and infected at birth. This is the reason triple panel screening of every adult, regardless of vaccination history, is recommended. People who decline or defer screening but accept vaccination should understand that vaccination will not alter a pre-existing infection, which is why hepatitis B screening is important for everyone.
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Immunize.org established Ask the Experts to provide practical answers to clinical questions about vaccines and vaccine administration. Our Immunize.org experts have answered more than 1,200 clinical questions like this one based on ACIP recommendations. You can find all of these questions and answers on our "Ask the Experts" page at www.immunize.org/askexperts.
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