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HBV Titer Employee Vaccinated by Previous Employer?

Q: I understand the employer is responsible to titer for Hep B after the series is complete. My question is regarding new employees that have documentation of a complete series but no titer. Are we responsible to get them titers? What if it has been longer than 2 months even 1-2 years do we still need to titer?

A: The CDC's Advisory Committee on Immunization Practices (ACIP) says not to do titers on employees several years after they were vaccinated because antibody concentrations decline over time, but healthcare workers (HCWs) remain protected.

For HCWs who have been vaccinated in the past but who do not have a documented titer showing response to vaccination, ACIP recommends HBV titers only if an exposure occurs.

If cost is not a great concern and the employer wants documented assurance of immunity, a revaccination series can be undertaken followed by testing 1 to 2 months after the 3rd dose of hepatitis B vaccine.

Frequently, the employer has (mistakenly) offered a titer to a new employee several years after they were vaccinated and the result was negative. This creates a difficult situation -- Did the employee not develop immunity from the series to begin with or was the vaccination effective but their antibody level now shows the normal decline over time?

There is no way to know for sure, so the best course of action is to offer the entire 3-shot series again. Of course, the employee may decline the re-administration of the series. If this is the case have them sign a declination form.

Fore more information check out Tab 5 for the Quality America OSHA Safety Program Manual, or Dental OSHA Safety Program Manual.

Posted by Quality America on June 14, 2007 | Comments (0)


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