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Thanks Amanda it is always useful to have the "green book" reiterated but my point was that although not in keeping with the green book at the time this is what we did, and interestingly levels did drop for no apparent reason so what has happened in the case we are debating may have been in keeping with the general population. Regards Sara From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Amanda Savage Sent: 18 September 2008 10:42 To: [log in to unmask] Subject: Re: [OCC-HEALTH] Blood loss affecting immunity Green book says check 8 weeks after number 3 so you know they have actually responded then boost at 5 years. If there is no response at HbAbs stage they need checking for natural immunity or infectivity. Regards Amanda Savage BSc(Hons); Sp Prac OH; RGN; DON; NEBOSH Senior Occupational Health Adviser West Midlands Fire Service Tel: 0121 380 7441 Mob: 07770863052 Email: [log in to unmask] <mailto:[log in to unmask]> P Please protect the environment - think before you print. Unless expressly stated otherwise, the information contained in this e-mail is confidential and is intended only for the named recipients. The information contained in this e-mail may be subject to public disclosure under the Freedom of Information Act 2000. Unless the information is legally exempt from disclosure, the confidentiality of this e-mail and your reply cannot be guaranteed. -----Original Message----- From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Sara Werry Sent: 18 September 2008 10:40 To: [log in to unmask] Subject: Re: [OCC-HEALTH] Blood loss affecting immunity Hi all In a previous employment a good few years ago! Our policy was to check serology at 3 years whatever the level after initial course and it wasn't uncommon for levels to of dropped from >100 to <10 we didn't really look for cause might have been interesting if we had at time. Of course now with not checking levels again but just boosting at 5 years you would never know how far levels have dropped as the theory seems to be that if you have ever responded to the vaccine when in contact with it the levels would raise. All best Sara From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Milne Campbell Sent: 18 September 2008 09:26 To: [log in to unmask] Subject: Re: [OCC-HEALTH] Blood loss affecting immunity I have hear of this too, This includes some Chemo treatments too -----Original Message----- From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of MICHAEL COCKAYNE Sent: 17 September 2008 20:55 To: [log in to unmask] Subject: Re: [OCC-HEALTH] Blood loss affecting immunity My point is that if you haven't got any proof of a responsive Anti-HBs from 2000 then there is no proof that her immunity has indeed been affected. However, I have seen someone who underwent immunotheropy and a tranfusion and was advised by her Consultant to have all her childhood imms courses repeated - tetnus, polio, dip ect. We also repeated her hep B course from scratch. ________________________________ Date: Wed, 17 Sep 2008 15:43:55 -0400 From: [log in to unmask] Subject: Re: [OCC-HEALTH] Blood loss affecting immunity To: [log in to unmask] In a message dated 17/09/2008 20:41:03 GMT Standard Time, [log in to unmask] writes: If you haven't seen any evidence of an Anti-HBs >10 from the course in 2000 then I would perform a full hep B serology, and if everything is okay offer her a second course of an alternative brand of the vaccine. Hope this helps Thanks for this Michael we've sorted out her vaccination but the question was would immunity have been affected by having had a significant blood transfusion? Thanks Glenn ~~~~~~~~~~~~~~~ Please remove this footer before replying. 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