HBV Vaccine FAQs
Telemedicine Consult - Dr. Gish
Schedule Telemedicine Consult with Dr. Gish

HBV Vaccine FAQs

HBV Vaccine FAQs

I have a patient who is positive for anti-HBc (hepatitis B core antibody) but negative for all other hepatitis B serologic markers. Should he receive hepatitis B vaccine?
If the positive anti-HBc is believed to be a true positive, the individual would not require vaccination since they have already (presumably) had HBV infection. Isolated positive anti-HBc could indicate low-level chronic infection.

Can you get hepatitis B testing after the vaccine?
It is best to wait at least three weeks before getting a hepatitis B test. If you are testing and vaccinating on the same day it is best to test then vaccinate.

What is an appropriate titer level for full protection? How long does that full protection last?
10IU/mL a Lifetime!

What if the vaccine is interrupted- do I need to restart the series?
For all ages, when the HepB schedule is interrupted, the vaccine series does not need to be restarted. If the Heplisav-B series is interrupted, the second (final) dose should be given as soon as possible. For Engerix-B, Recombivax HB, and PreHevbrio, if the series is interrupted after the first dose, the second dose should be administered as soon as possible, and the second and third doses should be separated by at least 8 weeks. If only the third dose has been delayed, it should be administered as soon as possible.

Can you use two different types of vaccines - the two-dose and three-dose and what does that schedule look like?
​​​​Data are limited on the safety and immunogenicity effects when Heplisav-B or PreHevbrio are interchanged with HepB products from other manufacturers. When feasible, the same manufacturer’s vaccines should be used to complete the series. However, vaccination should not be deferred when the manufacturer of the previously administered vaccine is unknown or when the vaccine from the same manufacturer is unavailable.

The 2-dose, 4-week HepB series for adults only applies when both doses in the series consist of Heplisav-B. Series consisting of a combination of 1 dose of Heplisav-B and a vaccine from a different manufacturer should consist of 3 total vaccine doses and should adhere to the 3-dose schedule minimum intervals of 4 weeks between dose 1 and 2, 8 weeks between dose 2 and 3, and 16 weeks between dose 1 and 3. Doses administered at less than the minimum interval should be repeated. However, a series containing 2 doses of Heplisav-B administered at least 4 weeks apart is valid, even if the patient received a single earlier dose from another manufacturer.

I’m a nurse who received the HepB series more than 10 years ago and had a positive follow-up titer (at least 10 mIU/mL). At present, my titer is negative (less than 10 mIU/ mL). What should I do now?
Do nothing. Data show that vaccine-induced anti- HBs levels might decline over time; however, immune memory (anamnestic anti-HBs response) remains intact following immunization. People with anti-HBs concentrations that decline to less than 10 mIU/mL are still protected against HBV infection.