It is not a requirement of EPP clearance that the employee has Hep B Immunity. They only need a validated series of test for infectivity for Hep B, C and HIV.
It is, of course, a good idea that they are immune but the sample does not HAVE to be IVS. Cellular memory is the term used to describe the capacity of the body's response following vaccination despite low or non-existent measures of Hep b antibodies in the blood.
Whilst we all aim to keep the exposed at levels above 100, they are of course immune at anything above 10 and in the event of an exposure, you'd give them a booster anyway.
I wold say that OH is encouraged to operate a public health function as well as an employer responsibility function so if a booster is indicated by low levels I would be inclined to offer. The difference is that you wouldn't push a booster on a reluctant individual or restrict them at work if they didn't want one.
Regards
Sue
Susan Gorton | OH Nurse Manager | Occupational Health Department | Great Ormond Street Hospital NHS Foundation Trust | Level 3, Ormond House, 26-27 Boswell St., London WC1N 3JZ |020 7405 9200 Ext 0247 | DD to OHD 020 78138554 | Direct Fax 020 78138355 | Mobile 07833294568
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-----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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