Hepatitis B vaccine

[DebE13]

An opinions on the Hep. B vaccine? My son, who has primary sclerosing cholangitis, got the series of three shots for hep B and was recently told it didn't take so he needs to go through them again. I spoke with a co-worker who is a paramedic and he said he wouldn't bother unless he plans to be in a profession that may come into contact with blood. I did not mention the PSC. My son is attending college with the intent to become a social worker. I am torn between pushing him to get the vaccine again and leaving it be. There are so many mixed opinions out there about all vaccines. If I don't encourage him to get it, he won't. But, my choice is affecting him and not me.

Would it be advisable that benefit involved with protecting his liver with the vaccine would outweigh the risks? The GI obviously recommends it but trust in them is nil.

[tex]

Would it be advisable that benefit involved with protecting his liver with the vaccine would outweigh the risks?

Unfortunately, virtually no specific information is available regarding the advisability of hep. B vaccination for PSC patients. I would think that it would be generally recommended, but I have no qualifying credentials in this area (as if I have any credentials in any area. LOL).

Incidentally, is he aware that he should avoid NSAIDs? They can lead to renal failure for patients who have chronic liver disease.

Here is an old article that covers information on hepatitis vaccinations for patients who have chronic liver disease (not specifically PSC). This article contains a lot of generally useful information, including a section on medications, vitamins, herbs, and minerals that may be toxic to the liver.

Preventive Care in Chronic Liver Disease

Here is a recent article that addresses this issue, but it doesn't appear to provide any new insight. However, it does offer links to many references. Both articles include a lot of references. Scanning them, I don't see any titles that suggest that they might offer any information on PSC, though.

Immunizations for patients with chronic liver disease

Tex

[DebE13]

Thank you! I value the opinions here more than anything. It at least gives me a good foundation to base my decisions.

Yes, i know about the NSAIDs but thank you for the reminder. The medical population is not familiar with that either. The GI said tylenol only. The PCP said absolutely no tylenol. Talk about getting into a panic. Called my GI to be sure I got it right and was told to ignore other doctors because they aren't familiar with it. Just recently, the nurse from the same GIs office scolded me for the tylenol. I lost my patience and she ended up telling me to do whatever the doctor said. I honestly don't try to be difficult but REALLY? I had hoped she would have confirmed it fir herself and gotten back to me to admit she made the wrong statement but there was nothing. I just keep researching on my own.

Looks like I have some more good information to read.

[Pat]

I am a dental hygienist so the dentist I work for and everyone in the office got the HepB shots many years ago. A couple of years later our dentist had us tested to see if we had the antibodies ( I think that is what they were looking for). Most of us were fine but the dentist had to go through the 3 shots again. He retested again and he still did not have the antibodies. They recommended to him to take them again, but also said that approx. 4% never get the antibodies. He chose to leave well enough alone. We've never tested again since then. I wonder about all vaccines. We get them but rarely do they ever test to see if we are immune to whatever we were vaccinated against.

Pat

[Zizzle]

I've read that people with celiac disease are likely to not develop the antibodies. I had the Heb B series in college as a healthcare worker, and years later showed no antibodies. I do have antibodies to Smooth Muscle (AMSA), the autoantibody for autoimmune hepatitis. The Hep B shot is highly implicated in triggering autoimmunity, so if it were me, I'd never go near it again.

[DebE13]

I had the shot about 20 years ago but never was tested to see if it worked.

Zizzle, interesting, I didn't know that. I hope to have him tested soon through enterolab to put my mind at ease or prove a point. Tonight for dinner he had a bowl of buttered noodles. I felt bad for him because he knows it bothers me but I also don't want to make him afraid to eat around me. He promised to eat an egg or something later......the lack of protein was secondary to the pasta (with no veggies).

I will have to gather my info on the vaccine and go through it with him. Too bad such choices weren't easier to make.