Hi Joanna,
You may find page 13 of the attached (albeit old) edition of viral hepatitis useful. It describes the decline of HBsAb over time. A booster dose of vaccine stimulates the immune response so a titre check 1-3 months post booster is more likely to give a more accurate picture of their true immunity.
The vaccine manufacturers should have resources including post-vaccination antibody response curves that graphically show this.
Paul
-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Joanna Edwards
Sent: 11 September 2013 08:53
To: [log in to unmask]
Subject: [OCC-HEALTH] Hep B antibodies and boosters
Dear All
I'm sure those of you working in the NHS have come across this before and I would value your advice please.
Sometimes we see new employees for exposure prone procedures clearance who have not had validated bloods taken for HBV Abs in their previous employment. Although they might have formerly demonstrated good immunity immediately after their initial course of HBV vaccinations, on repeating the test here in order to provide the required validated sample, they may only demonstrate a 10 -99 level (at which point should we then be giving an immediate booster?) or even, more rarely a <10 level (indicating the need for a repeat course?).
I'm unclear about required action here and am looking for the evidence for either doing/not doing this. My understanding is that although there may be an apparent reduction in the number of antibodies, immune memory would ensure good protection. Do we therefore need to provide further vaccine?
Very grateful for your advice or link to any evidence so that we can develop guidance for future management.
Many thanks as ever!
Jo
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