[MCOH-EH] Hep B and Non Responder Status

[Wintermeyer, Stephen F.]

I have given intradermal to non-responders based on data from the 1990’s out of Connecticut, showing 88% of such patients show evidence of response after the Intradermal dosing.  Our success rate (100%) has been excellent, albeit in a small sample (N=4).

Stephen Wintermeyer, MD, MPH
Director, IUPUI Campus Health
Associate Professor of Clinical Medicine
Division of Pulmonary, Critical Care, Sleep and Occupational Medicine
IU School of Medicine



From: MCOH-EH [mailto:mcoh-eh-bounces+swinterm=iu.edu at mylist.net] On Behalf Of Abhijay Karandikar via MCOH-EH
Sent: Saturday, September 23, 2017 5:02 PM
To: MCOH/EH <mcoh-eh at mylist.net>
Cc: Abhijay Karandikar <dr_abhik at yahoo.com>
Subject: Re: [MCOH-EH] Hep B and Non Responder Status

Taking this a little further, is anyone administering high dose (dialysis dose) vaccines or intradermal doses to non responders? If yes, what has been your conversion rate? How do you "sell" these approaches to your employees (show them PubMed articles, other research, etc.)?

Abhijay


Abhijay P. Karandikar, MD, MPH, FACOEM
Medical Director - Occupational Medicine & Employee Health Clinic

________________________________
From: "Hanna, Raye Nell" <HANNAR1 at covhs.org<mailto:HANNAR1 at covhs.org>>
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Sent: Friday, September 22, 2017 3:11 PM
Subject: Re: [MCOH-EH] Hep B and Non Responder Status

We give 6 vaccines and a negative HBSAB before we call them a non-responder.

Raye Nell

Raye Nell Hanna, RN, MPH, COHN-S
Manager Employee Health
Covenant Health
3606 19th St
Lubbock, TX 79410
Phone (806) 725-0098

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Lisa Dyrdahl
Sent: Friday, September 22, 2017 2:04 PM
To: MCOH/EH
Subject: [MCOH-EH] Hep B and Non Responder Status

I have a question about Hep B and Non Responder Status:

I cannot find the citation but I read that HCWs can be considered Non Responders in one of two ways
•         After the 4th Hep B Challenge dose is given and the Hep B Titer and HBSAG are negative
•         Or, you can continue the 2nd series of Hep B through dose #6 and consider Non Responder if the Titer and HBSAG are negative

I cannot  find where I read this now.  Do we have to give the Hep B series twice, (6 doses) before declaring Non Responder, or, do we have an option to do this after the 4th Hep B Booster/Challenge dose and the titer and HBSAB are negative?

Thanks
Lisa Dyrdahl, RN, BSN
Employee Health Nurse
Lisa_Dyrdahl at Valleymed.org<mailto:Lisa_Dyrdahl at Valleymed.org>
Ph: 425-228-3440 X5720
Fax: 425-656-5066
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