Non-responder to Hep B vaccine

Hi everyone

I have a question…

I’m just over 2 years post-transplant for Acute Myeloid Leukaemia, and have had to have the Hep B vaccine for my work. I had one, but the blood test afterwards indicated I hadn’t mounted an immune response (which happens, they said) - so I was given another. However, today I got an email saying I was a non-responder to the vaccine, and that I need to speak to Occupational Health. The appt isn’t for a few weeks.

Is it possible I haven’t mounted an immune response because my immune system isn’t strong enough? After my first couple of covid jabs, I did an antibodies test for Cancer Research, which indicated I did create antibodies for covid (although I don’t know the quality/quantity.)

I think I may have had the Hep B vaccines successfully in my previous pre-cancer life, but I’m not sure. I’ve travelled and worked overseas extensively - would they have been a visa requirement anywhere? And presumably any Hep B vaccine antibodies would have been destroyed during my treatment, like those of my childhood vaccines - so could being a non-responder be a new status for me, and not something I always was? I’m certain I’ve never been termed this before.

If so, what next? Are there other Hep B vaccines to try? I’m worried this could put my job in jeopardy - having the vaccine is an essential requirement for the post, for my safety and others’.

And another thought: I couldn’t have Hep B, could I? I’ve had dozens of blood transfusions. Hep B doesn’t ever slip through the net, does it?

Thanks ever so much.



Sorry to hear this and i hope your Occ Health appt can shed some more light on it all. As could speaking with your Haematology team. You mentioned having blood transfusions - if these were all in the UK, we have tested for a variety of blood borne viruses for well over 30yrs now so thankfully, they don’t slip through the net anymore! I really hope you get answers and next steps soon. Every good wish to you


Thanks so much, @judesadventures. Yes, perhaps I could ring the haematology dept tomorrow.

I’ve just googled which areas travellers are advised to get the Hep B vaccine, and it includes Africa and Asia, so I must have previously had the vaccine, as I’ve worked in both regions - and I’m conscientious about things like that. Oh dear!

Thanks a lot. Hope all’s well with you.


Hi @Fullofbeans your post is very interesting to me.
I was diagnosed in 2003 with Chronic lymphocytic leukaemia (CLL), I have never had any treatment, always being on watch and wait.
In 2005 I also needed to have a Hep B vaccine for me to continue working, I have just got my records out, and I had Hep B vaccines March 05, May 05, Oct 05, and Sept 06 and I think, but I am not sure, my Dr said that none of them had ‘converted’.
Anyway I kept my employer ( a private hospital) documented in writing and in the end they just gave up chasing me.
Anyway I will copy your post to the Blood Cancer UK nurse advisors
@BloodCancerUK_Nurses in case they can add anything.
Look after yourself and keep me posted


Oh that’s very interesting, @Erica - thank you. Could you have had the Chronic lymphocytic leukaemia (CLL) up to 8 years before your diagnosis, I wonder? Could it be the Chronic lymphocytic leukaemia (CLL) causing your non responder status? Or perhaps you were just naturally a non responder?And interesting the hospital just gave up chasing it! Although I don’t think my employer will. And I’d be a bit scared to carry on working there without it, anyway, I think.

Thank you too for copying to the nurses - I’ll be very interested to hear what they say. Until today, I had no idea this could possibly be an issue.

Hope you’re ok, @Erica? You work so hard here. You and all the forum volunteers are certainly NOT non responders where replying to everyone’s worries are concerned. :blush: X


Oh @Fullofbeans terribly sorry the Hep B vaccinations must have been 05-06.
No I know I did not have the Chronic lymphocytic leukaemia (CLL) much before diagnosis.
I will alter my post above.
I have also remembered (whilst in the bath) it was for my Practicing Privileges.
I worked at the hospital for quite a few years after.
Look after yourself


Ah ok, thank you @Erica. Things always come to us while in the bath! :smile: X


Dear @Fullofbeans

Thank you so much for posting and I am sorry to hear that you have been having problems mounting a response to your Hepatitis B vaccines. It must be very stressful managing this, may I ask if you have spoken to the Transplant Team monitoring you about this issue? I have emailed the team at Anthony Nolan today to see if they have any resources regarding this so will let you know once I hear.

I would just like to reassure you that the blood transfusions you had as part of your care would not have potentially infected you with any virus at all, please see the Blood transfusion - NHS ( webpages that state:

Blood transfusions are common and very safe procedures.

All donor blood is checked before it’s used to make sure it does not contain serious infections such as hepatitis or HIV.

I am going to do some research about this and see what I can find for you. I would suggest that you do contact your Haematology Doctors/CNS’s so that they can also support you with this. They may be able to contact the Virology or Infection control teams within the hospital to ask their advice regarding vaccinations.

I will forward you anything I hear from the Anthony Nolan and any further reading I do.

Kind regards


Ah thank you SO much, @GemmaBloodCancerUK - firstly for the reassurance, and secondly for all the help, contacting Anthony Nolan and researching etc.

I tried my local haematology team today, but couldn’t get hold of anyone. I’ll ring my transplant hospital tomorrow and see what they say. I did have mixed responses from the consultants there when I started the job - some felt it a bit risky, others that I should go for it. I felt safe at work though, thinking I was vaccinated - but being a non responder changes that quite a bit.

Okay, i’ll let you know what I find out too.

Thanks once again.

Fullofbeans. X


You are most welcome, still waiting to hear back but did just read from the NHS ‘If you have a weakened immune system or you’re on kidney dialysis, the hepatitis B vaccine may not work as well as usual. You may need more frequent doses.’ So it may be, with your Transplant Teams support you will need more doses to mount a response but worth chatting with them and if I find anything more I will be straight in touch.
Speak soon,


Hi @GemmaBloodCancerUK
Ah that’s interesting - hopefully then, I can keep trying with the vaccines until eventually I respond. And then keep topping it up a bit more frequently. That would be good news.
Thanks so much.


Like you I had Acute Myeloid Leukaemia and bone marrow transplant just over two years ago. However pre cancer I was working as a nurse and despite having several accelerated doses of Hep B Jab I never reached immunity and so was working as a non responser throughout this time. I’ve worked in what might be classed as higher risk areas in Mental heath acute/rehab settings and drug support services and have ‘managed’ the risk. None of my employers have never had a problem with this. I think just adhere to all the infection control protocols, after all there’s plenty of other nasty viruses out there, that you can’t be immunised for?
I’m just returning to work and have discussed with my transplant team whether it would be advisable /beneficial for me to try again with my ‘new immune system’ to have the Hep B jab, they are happy to leave me to decide. I’m leaning towards not having it and just taking all precautions as I have done pre cancer. Much care


Hi @Deborah26

That’s interesting - thanks so much. Like you, I do work in a riskier area, and I may well come into contact with Hep B - so being vaccinated is a requirement of the post. I’m seeing OH soon, to try again, as it seems it may take several attempts to get a response. I was a responder to the vaccine pre-transplant, so (I think) that’s hopeful! I don’t know how insistent my employer will be about the vaccine if I don’t ever respond.I can’t imagine them wanting to lose anyone - I should think most employers are desperate to hang on to staff in these days of staff shortages.But similarly, if my immune system can’t respond to a vaccine, I dont really want to test it with a nasty BBV.

It has also made me wonder if I’ve responded well to any of my vaccines, although I’m not particularly worried about those.

Great to hear you’re going back to work too, @Deborah26. It helps to draw a line under the illness years and feel more normal again, doesn’t it? Are you going back full time? I stupidly tried that without a bit of a lead in to it, and it was too much for me, but 21 hours seems about right for me, after some trial and error. I hope you get the balance right for yourself.

Best of luck! X

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