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@mylist.net]
On Behalf Of Abhijay Karandikar via MCOH-EH
Sent: Saturday, September 23, 2017 5:02 PM
To: MCOH/EH <mcoh-eh@mylist.net>
Cc: Abhijay Karandikar <dr_abhik@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@covhs.org>
To: MCOH/EH <mcoh-eh@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@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
Ph: 425-228-3440 X5720
Fax: 425-656-5066
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