Not hep b + but hight hbsag ab years after vaccination

I had an adverse reaction to a hep b vaccine years ago (19 years ago). My titers for HBSAG AB are still 253IU/L and my liver enzymes are elevated. COuld this indicate a continuing autoimmune over response to the vaccine? I have had many chronic fatigue like symtpoms since the vaccine.

Thanks for joining the group! Do you remember what your adverse reaction was to the hepB vaccine 19 years ago? Rash, hives, trouble breathing? Although I’m not an immunologist or a physician, I know there are no studies to support the idea that the hepB vaccine could cause an autoimmune reaction/disease. There are anti-vaxxers who believe that this vaccine (and many of the other vaccines) can cause autism and auto-immune diseases, but the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) have stated that the hepB vaccine is safe. With that said, I hope that you have a good doctor who can help you figure out why your liver enzymes are elevated since they can increase for many different reasons; therefore, should be checked out. Hopefully there are other folks/scientists on this forum who might be able to add to my response. Thanks, Joan

My reactions were visual disturbances, tingling/numbness in left leg, cognitive issues, insomnia, depression, lesions on MRI.

The WHO GACVS committee on vaccine safety used this scientists first study as support for the safety of Hep B vaccine. This is his follow up study indicating the vaccine I received (Engerix B) can cause these reactions. And I don’t consider myself an anti-vaxxer. Also, the Vaccine Injury Court in USA does pay damages to people who reacted adversely to Engerix B vaccine. I however live in Canada and we do not have any remediation for injuries occuring from vaccines.

What I really wanted to know is about the HBSAG AB titers. If it’s an indicator of an autoimmune syndrome? Or if there is some kind os scale or various lab tests together that may identify this?

Hi Howard,

The HBV surface antibody titres mean that you are still protected against HBV. I would probably not say that this is a signal that there’s a continued “auto-immune” response, but it’s hard to say because everyone is so different.

I’m not aware of any CNS reactions to the HBV vaccine - the paper you linked to has the conclusion that in general the vaccine is not linked to increased risk. They report if you limit the analysis to Energix, there is a slight increased risk.

BUT I don’t have access to the actual paper, so it’s hard for me to tell if these results are interpreted correctly. There are at least two commentaries in the same issue denouncing the interpretation of the results (here and here), so I think it is best to take this with a grain of salt. It is common to find statistically significant things when you try to compare a lot of things at once, so results like these really need to be confirmed in larger populations or independent groups. Another point against it is that this study was published 12 years ago, and there hasn’t been much follow-up on it, which would suggest that they tried to confirm it and didn’t find anything worth publishing.

It is possible that your symptoms come from something that happened at the same time as when you got the vaccine. It really is hard to tell over the internet or even face-to-face. This does require someone with specialised knowledge like a rheumatologist to do the appropriate tests to find out what’s going on.

Hope this helps a bit.


Thanks for the info Thomas. I have a complicated medical history, as I already had chronic fatigue syndroem from a viral infection (EBV) as a teenager and I developed post viral chronic fatigue after that. I found information on Chronic Fatigue and vaccination in a document put together by Health Canada titled, *Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Clinical Case Definition and Guidelines for Medical Practitioners. It states:

Immunization*: Live vaccine immunization is
generally not recommended because of the risk of
worsening symptoms and triggering relapses.
Research has confirmed a frequent dysfunction of
the 2-5A synthetase/ribonuclease L antiviral
defense pathway in many patients3
. Because of
these risks, decisions regarding vaccinations must
remain with the treating physician and the patient.

No medical history was taken from me at the time of vaccination in a medical laboratory where I worked. The vaccine was administered by a medical doctor, who was also our director. The Vaccine Injury Court also pays damages for injuries from Engerix B. I understand that the whole vaccine argument is a quagmire, but these two things verify there can be an issue with this vaccine. Even the drug insert confirms the possibility of these side-effects, so they are very real.

I will take your advice and try to see a rheumatologist. Is there any test specifically I should ask for?

No problems. I’m sorry that you’re in such a situation.

As you say, it will be difficult to link the vaccine to your symptoms. The statement you give mentions live vaccine vaccination (that is, using a weakened form of the virus to train the body to fight it), however engerix is a subunit vaccine (which is just a piece of the virus with no genetic material whatsoever and completely unable to infect or replicate in cells).

I really don’t know enough about immunology to be able to tell you which tests to ask for. I would basically state the concerns you have here and go by their recommendations.

I hope everything works out OK.


My sincere apologies if you felt I was suggesting you were an anti-vaxxer. That was definitely not my intention! With that said, I really agree with what Thomas wrote. He always write very carefully and knowledgeable. Just like you would expect from a serious scientific researcher that he is. So glad he’s leading this forum! And best wishes Howard as you search for answers to your complex medical issues. It cannot be easy living with the chronic fatigue. A condition/disease that is not well understood. Please keep us posted us on what you learn so if there are any folks like yourself who join the conversation, then they can learn from you as well. Thanks again, Joan

Thanks Joan:) I didn’t want to start the whole vaccine debate, as I’m quite aware of each side’s stance. If I didn’t experience what I did, I wouldn’t have a clue about all of the nuances. I think there is a reason the Vaccine Injury Court does allow submissions for injuries from Engerix B. Many of my symptoms I’ve experienced are identified in the product insert of Engerix B vaccine. It seems like there are two narratives here. The scientific community saying the vaccine is safe, and then the manufacturer and Vaccine injury Court saying you can experience adverse reactions like mine. There must be some degree of verification of these reactions and a legal responsibility via the Vaccine Injury Court to rectify them as well. I agree with vaccinations, as long as predispositions and people at-risk of suffering adverse reactions like mine are properly screened to receive them. At this point, I just want to find out how or what to test for to see if I have an autoimmune condition relating to this so I can treat it properly. All I wanted to know was which tests may be applicable to determine this and what treatments may be available for this. Thanks for reaching out.

I am very sorry to hear you have ongoing symptoms of chronic fatigue etc, as these can be very debilitating and difficult to manage for many people.
Concerning your post, I am also not aware of any link between HBV vaccine and autoimmune conditions, and agree with Thomas that I would take that paper with a grain of salt.
The good news is that your persistently high titres for anti-HBsAg antibody reflect a good immune response to the vaccine (providing anti-viral immunity, not auto-immune response), so you are well protected against hepatitis B. This is exactly what we would expect to see in someone with a good vaccine response.
Concerning the persistently elevated liver function tests this could be for many reasons, but is not due to hepatitis B or the HBV vaccine. I suggest you see a Hepatologist to look into this.

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I respect your opinion, but the Engerix B product insert specifically mentions several of the problems I am having, including Hepatic system disorders and abnormal liver function tests, as well as a myriad of other conditions. They indicate this data is based on data from over 5300 individuals who received the vaccine. Has the manufacturer used false data in their product insert?

Here is the link for the Engerix B product insert.

Hi Howard,

Thanks for the link. After reading it, I can see that the table there does say some (relatively minor) adverse effects are linked to the vaccine (section 8.1. the table mentioning “more than 5300 subjects”). These are indeed things that were picked up in clinical trials prior to wide-spread adoption of the vaccine and this data shows the relative safety of the vaccine.

The symptoms you describe seem to be describing are in the “Post-Market Adverse Reactions”: these include the more severe issue you mention. This is a list of symptoms that people report after they get the vaccination (just as you are at the moment). However, these are reports from uncontrolled conditions in real-world use. We can’t link this specifically to the vaccine just because they happened at around the same time: a lot of things can happen at the same time, but are not linked. Indeed, this table does include specific disorders that have been shown not to be linked to the vaccine (asterisked, “A number of studies have demonstrated no link between hepatitis B vaccine and multiple sclerosis, Guillain-Barre syndrome (GBS), ….”). This information is provided for transparency and is a way of saying “people have reported these symptoms”, but without saying anything on the truth of if that link is real or not (because each of these would take huge amounts of resources to test).

So, I don’t think the manufacturer is using false data on the product insert nor do I think the scientific community is out of line with their data. I think the insert is providing different information for transparency (and probably part of the legal requirements).

Hope this makes things a little clearer.