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Hepatitis B in a vaccinated soldier: a case report
Keri McLean1,2, T B Elmer3, D A Freshwater4
1Tropical and Infectious Diseases Unit, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK.
Journal of the Royal Army Medical Corps
|August 25, 2018
Summary
Hepatitis B vaccination is recommended, but antibody titres are not routinely checked. A vaccinated infantry soldier contracted hepatitis B, highlighting the need for considering this diagnosis in military personnel with symptoms.
Area of Science:
- Immunology
- Vaccinology
- Hepatology
Background:
- Hepatitis B vaccination is crucial for preventing infection.
- Current UK guidelines recommend antibody titre checks only for high-risk occupations.
- Routine assessment of immunological response post-vaccination is not standard practice.
Observation:
- An infantry soldier completed the hepatitis B vaccine series.
- The soldier subsequently developed acute hepatitis B infection.
- This occurred despite documented vaccination.
Findings:
- A complete hepatitis B vaccination course did not confer complete immunity in this case.
- The patient experienced acute hepatitis B despite vaccination.
Implications:
- Hepatitis B remains a significant differential diagnosis in symptomatic military personnel, irrespective of vaccination status.
- This case challenges the assumption of guaranteed immunity post-vaccination in all individuals.
- Further consideration of post-vaccination surveillance may be warranted for specific high-risk groups within the military.
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