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Immunization FAQ

Understanding Vaccines and Proving Immunity

 

Vaccine

Evidence of Immunity

Post-Vaccination Serology

Follow-up for Negative Post-Vaccination Serology

Hepatitis B

Documentation of three doses of appropriately-spaced hepatitis B vaccine, or

Laboratory evidence of immunity (i.e., a positive titer).

Not recommended due to potential for falsely-negative results EXCEPT for people who may be at risk for exposure to blood borne pathogens, such as health professional students.

Post-vaccination testing of health professional students should be performed 1-2 months after completion of the three-dose series of Hepatitis B vaccine.

Repeat a three-dose series of hepatitis B vaccine, followed by a titer 1-2 months after series completion.

If the repeat titer after two series’ of hepatitis B vaccine is negative, a person is considered to be a non-responder to Hepatitis B vaccine.

(For more information about Hep B Titers, see below)

MMR

Documentation of two doses of appropriately-spaced MMR vaccine, or Laboratory evidence of immunity (i.e., a positive titer), or Laboratory confirmation of disease, or Born before 1957.

Not recommended due to potential for falsely-negative results.

May be assumed to be falsely-negative and disregarded. Additional doses of MMR vaccine are not recommended.

Tdap

Documentation of one dose of Tdap vaccine.

Not commercially available.

N/A

Varicella

Documentation of two doses of appropriately-spaced varicella vaccine, or

Laboratory evidence of immunity (i.e., a positive titer), or Diagnosis or verification of a history of varicella or herpes zoster by a health care provider,

or Born before 1980.

Not recommended due to potential for falsely-negative results.

May be assumed to be falsely-negative and disregarded.

Additional doses of varicella vaccine are not recommended.

 

 

What is a Hep B Titer?

A titer is a blood test, drawn to determine immunity to Hepatitis B.   Immunity usually occurs after 3 appropriately given Hepatitis B vaccines.

What will the results of the Hep B Titer show?
It will show that you have immunity to Hepatitis B = POSITIVE. Or indicate that you do not have immunity to Hepatitis B = NEGATIVE.
 
I got a Hep B titer and it was POSITIVE, do I have to repeat the test yearly?
NO, once you have received a POSITIVE Hep B TITER result and your results are recorded you DO NOT have to repeat the titer.
 
I got a Hep B titer and it was NEGATIVE, what should I do?
First determine if you received all three Hepatitis B vaccines by looking at your vaccine record. If you did not receive 3 vaccines then you should complete the series. Have the titer drawn again, but no sooner than 30 days after the last Hep B vaccine you receive.
 
I did receive 3 Hepatitis B vaccines and still have a NEGATIVE titer, what can I do?
Before being revaccinated, have a Hep B Surface Antigen Test (HBsAG) performed. This test will rule out if you are a carrier of Hepatitis B.
 
I just got the Hep B Surface Antigen Test done (HBsAG) and it said I was NEGATIVE or NON-REACTIVE, what should I do?
You may now begin the Hep B series of 3 vaccines again. It is suggested that you have a Hep B Titer drawn no sooner than 30 days after each subsequent vaccine to see if you have achieved immunity.  Many people obtain immunity after only one subsequent vaccine. Once POSITIVE immunity is determined you will not need any more vaccine. No one should receive more than 6 vaccines in total. 
 
I just got the Hep B Surface Antigen test done (HBsAG) and it said I was POSITIVE or REACTIVE, what should I do?
It is likely that you are a carrier of Hepatitis B. You will need to be evaluated by an MD to determine an appropriate plan of care. You will be counseled regarding prevention of Hep B transmission to others.  YOU WILL NOT receive any additional Hepatitis B vaccines or titers.
 
Did you know?

...that certain vaccines are recommended for adults and adolescents? Take this quiz to find out which vaccines YOU may need: http://www2.cdc.gov/nip/adultImmSched/