[MCOH-EH] Hepatitis B and titers

Brenda Kantner bkantner at schuylkillhealth.com
Wed Sep 24 06:44:31 PDT 2014


It is unfortunate that even though there were new 2013 CDC recommendations, there are still so many individual decisions that need to be made with regard to Hep B for healthcare workers. Nothing is ever totally clear-cut, but there are still so many questions. 

 

We still struggle with many new hires not having documentation of their Hep B vaccines given in the past. Previously, we would titer new hires

if the employee "was sure" they completed the series in the past. In most cases now, based on the newest recommendations, we repeat the series or get a declination rather than titer if there is no documentation of the three vaccines.

 

 

Brenda Kantner RN COHN-S/CM
Employee Health Coordinator
Schuylkill Medical Center
700 East Norwegian St
Pottsville, PA 17901
Phone 570-621-4351
Fax   570-621-4257
bkantner at schuylkillhealth.com



________________________________

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Adamo, Philip
Sent: Wednesday, September 24, 2014 8:40 AM
To: 'mcoh-eh at mylist.net'
Subject: Re: [MCOH-EH] Hepatitis B and titers

 

Good morning all:

I am interested in how your institution handles Hep B titers at pre-placement

The 2013 CDC recommendations state: 

"All HCP recently vaccinated or recently completing HepB vaccination who are at risk for occupational blood or body fluid exposure should undergo anti-HBs testing. Anti-HBs testing should be performed 1-2 months after administration of the last dose of the vaccine series when possible. HCP with documentation of a complete ≥3-dose HepB vaccine series but no documentation of anti-HBs ≥10 mIU/mL who are at risk for occupational blood or body fluid exposure might undergo anti-HBs testing upon hire or matriculation. Testing should use a quantitative method that allows detection of the protective concentration of anti-HBs (≥10 mIU/mL) (e.g., enzyme-linked immunosorbent assay [ELISA])."

The word "might" is not good especially when mid level providers work off protocols. This is also different then what figure 6 implies.We also know and the literature supports that the measurement of immunity wanes over time. My recall is that after 7 years it is difficult to measure the immunity greater than 10. There is also literature that those who receive the vaccine in infancy have undetected immunity in adulthood; however, they are immune to Hep b. 

Based on this information, I have in previous hospitals set a standard of giving a booster for those with documented 3 doses and more than 7 years and then checking the immunity with a titer rather than checking a  titer, getting an non immune response, administering a booster and checking again. Any thoughts on this?

 

Thanks,

Phil

 

 

Philip Adamo, M.D., MPH, FACOEM

Associate Vice President and 

Medical Director, Employee Health &

Occupational Injury Care and Wellness

UMass Memorial Medical Center

Hahnemann Campus Suite 201

291 Lincoln Street

Worcester, MA 01605

Phone: 508-334-6179 

FAX: 508-334-6433 

cell 508-713-3993 

philip.adamo at umassmemorial.org

 

"THE GREAT USE OF LIFE is to spend it for something that will outlast it."

William James

 

 

 

________________________________

The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential and/or privileged material. Any review, transmission, re-transmission, dissemination or other use of, or taking of any action in reliance upon this information by persons or entities other than the intended recipient is prohibited. If you received this in error, please contact the sender and delete the material from any computer.

-- 
This message has been scanned for viruses and dangerous content by 
E.F.A. Project <http://www.efa-project.org> , and is believed to be clean. 
Click here to report this message as spam. <http://smcens-efilter.papot.ahealth.org/cgi-bin/learn-msg.cgi?id=0394510DBAF.AE67A&token=de5557730d179bbbf3b615c1f5312470>  


CONFIDENTIALITY NOTICE: This email message and any accompanying data or files is confidential and may contain privileged information intended only for the named recipient(s). If you are not the intended recipient(s), you are hereby notified that the dissemination, distribution, and or copying of this message is strictly prohibited. If you receive this message in error, or are not the named recipient(s), please notify the sender at the email address above, delete this email from your computer, and destroy any copies in any form immediately.  Receipt by anyone other than the named recipient(s) is not a waiver of any attorney-client, work product, or other applicable privilege.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://mylist.net/archives/mcoh-eh/attachments/20140924/8f00a280/attachment.html>


More information about the MCOH-EH mailing list