[MCOH-EH] MCOH-EH Digest, Vol 252, BBP exposures

[Harriman, Kathleen (CDPH-CID-DCDC-IMM)]

The CDC Guidance for Evaluating Health-Care Personnel for Hepatitis B Virus Protection and for Administering Postexposure Management, Recommendations and Reports, December 20, 2013 / 62(RR10);1-19 (https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6210a1.htm) states that anti-HBs greater than or equal to 10 mIU/mL should only be used as a correlate of protection for HCP with documentation of a complete HepB vaccine series.  HCP who lack documentation of a dose or doses of HepB vaccine should be considered unvaccinated for those dose(s) for which documentation is lacking.  Please refer to Table 2 in the above referenced MMWR for the post-exposure management protocol, including for unvaccinated or incompletely vaccinated HCP.    

Kathleen Harriman
Immunization Branch
California Department of Public Health
kathleen.harriman at cdph.ca.gov


Date: Tue, 14 Nov 2017 18:18:46 +0000
From: "Grubbs, Scott" <Scott_Grubbs at bshsi.org>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] BBP exposures

While the person does need to complete the series for long term immunity assurance, for the exposure of the moment, it would seem reasonable to think that they have the right antibodies to deal with it.  However, I am not an ID doc, so that is just my opinion.
Scott Grubbs, MD
WorkWell Occupational Health
Greenville, SC

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Tim Crump
Sent: Monday, November 13, 2017 12:43 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] BBP exposures

I would be interested in knowing how people are testing workers who have not completed the Hepatitis B immunization series.  Our staff who sustain a needle stick or other BBFE afterhours are seen in the ED, where they do not necessarily know their immunization status.  They test everyone w/ HepB sAb.  My understanding of CDC recommendations is that workers who have not completed the series should be tested w/ HepB core Ab, and that surface antibody is uninterpretable if the immu series is not complete.  So my question is, can the HepB surface antibody be used as a marker of immunity to Hep B at that moment, or is it misleading and should be put aside when the immu series is incomplete, potentially making a worker a candidate for HBIG?  Thanks for any insight, Tim

Tim Crump, MSN, FNP
Family Nurse Practitioner
Multnomah Pavilion 1 SE, Suite 1110
Occupational Health
Healthcare Human Resources

Oregon Health & Science University
3181 SW Sam Jackson Park Rd
Mail code: UHN 89
Portland, OR 97239-3098
Department Phone: 503-494-5271
Office Phone: 503-346-1152
Fax: 503-494-4457
Email: crumpt at ohsu.edu<mailto:crumpt at ohsu.edu>