[MCOH-EH] Incompletely Vaccinated HepB & Immunity Titers

[Leslie Thompson]

We do the same.  Because CDC recommends otherwise we took it to our ID group for approval.  I understand the CDC recommendation to ensure long term protection, but it is costly to repeat doses on previously vaccinated employees.   For those that are ”certain” of their history of vaccine, we accept the positive titer.   Especially post-exposure.  A false positive anti-HBs is unlikely given the history of vaccination.  CDC provides great guidance and we faithfully follow most of it.  If you look at post-exposure recommendations, even UCSF clinical consultation center has differed in their post-exposure recommendations and cites the studies they base their difference of opinion on.  I suggest taking to your ID for their input as you need organizational support in whatever approach you take.


Leslie

Leslie Thompson, RN, MSN, ANP
Manager, Employee Occupational Health Department
Sharp HealthCare
8695 Spectrum Center Blvd
San Diego, CA  92123
leslie.thompson at sharp.com<mailto:leslie.thompson at sharp.com>
P: 858-499-5264 F:858-499-5317

[badge-5968]


From: MCOH-EH <mcoh-eh-bounces at mylist.net> On Behalf Of Seeburger, Sara
Sent: Tuesday, July 10, 2018 17:32 PM
To: MCOH/EH <mcoh-eh at mylist.net>
Cc: fldocstu at aol.com
Subject: Re: [MCOH-EH] Incompletely Vaccinated HepB & Immunity Titers

[EXTERNAL SENDER]
We utilize the attached guidance to decide what to do for situations like these, and have found it very helpful.  It does address the situations you referred to below.  Having said that, in many instances employees who know they had the 3 vaccines in the past (but have no proof) and have a positive titer, sometimes decline the second series.  We would check their titer again if they are exposed to an unknown source or positive Hep B source, to ensure they are protected at the time, and treat accordingly using “table 1”.

Thank you,

Sara Seeburger RN, BSN
Director Occupational Health
Centura Health
9100 E. Mineral Circle
Centennial, CO 80112
303-765-6498 Phone
720-874-5955 Fax





.

From: MCOH-EH [mailto:mcoh-eh-bounces+saraseeburger=centura.org at mylist.net] On Behalf Of Stuart Sandler via MCOH-EH
Sent: Tuesday, July 10, 2018 6:33 AM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Cc: fldocstu at aol.com<mailto:fldocstu at aol.com>
Subject: Re: [MCOH-EH] Incompletely Vaccinated HepB & Immunity Titers

List,

I may be missing something, so ask for enlightenment.  If someone comes in knowing that they had the 3 series of HepB vaccine and you receive a positive HepBSAb titer on your pre-hire testing, why would you give a repeat series if the person cannot produce written documentation of the vaccines?  I received my vaccines many years ago and the institution is no longer available to ask for records, nor did we think of that at the time.  Would not the positive titer itself suffice for proof of immunity?  I have not been asked in the past by any employer or hospital for proof of vaccine, just proof of immunity.


And what do you do with a person who doesn't remember if they had ever been vaccinated (happens more times than I can count), yet has a sufficient HepBSAb titer?  It doesn't mean that they never received the series.  Then, too, what do you do if the person received two vaccines only, but has a significantly positive titer?  Why would you give them the third, especially if it had been a while since the first two? For example, I became significantly symptomatic after my second vaccine (OK, it WAS in the stone ages at the early start of vaccinations and they weren't as refined as they are curently), so a titer was done prior to getting the third.  I had a high Ab titer, so it was decided that I had been properly immunized and that the risks of having the third were outweighed by the possible of a worsened reaction.  BTW, I had a documented 0 titer prior to the vaccine series.

Just curious.

Stuart A. Sandler, DO


-----Original Message-----

Today's Topics:

1. Re: #ExtMail# Incompletely Vaccinated HepB & Immunity Titers
AND ? requiring Hepatitis B vaccination for employees?
(Schweitzer, Kit)


----------------------------------------------------------------------

Message: 1
Date: Mon, 9 Jul 2018 22:32:14 +0000
From: "Schweitzer, Kit" <KSchweitzer at peacehealth.org<mailto:KSchweitzer at peacehealth.org>>
To: "MCOH/EH" <mcoh-eh at mylist.net<mailto:eh at mylist.net>>
Subject: Re: [MCOH-EH] #ExtMail# Incompletely Vaccinated HepB &
Immunity Titers AND ? requiring Hepatitis B vaccination for employees?
Message-ID:
<MWHPR10MB1488B9A500DFCC0A0C27A544B1440 at MWHPR10MB1488.namprd10.prod.outlook.com<mailto:MWHPR10MB1488B9A500DFCC0A0C27A544B1440 at MWHPR10MB1488.namprd10.prod.outlook.com>>

Content-Type: text/plain; charset="us-ascii"

We require documentation of 3 Hep B vaccs AND positive titer to ensure life long immunity as recommended by CDC. We start the series over if they don't have documentation and only a titer. If documentation and no titer, we draw a titer.
Thank you.

*****************************************************************************
This communication is for the use of the intended recipient only. It may
contain information that is privileged and confidential. If you are not the
intended recipient of this communication, any disclosure, copying, further
distribution or use thereof is prohibited. If you have received this
communication in error, please advise me by return e-mail or by telephone and
delete/destroy it.
*****************************************************************************
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <https://mylist.net/archives/mcoh-eh/attachments/20180711/46b90422/attachment-0001.html>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image001.png
Type: image/png
Size: 12866 bytes
Desc: image001.png
URL: <https://mylist.net/archives/mcoh-eh/attachments/20180711/46b90422/attachment-0001.png>