When should postvaccination anti-HAV testing be performed?

Serologic testing for immunity to hepatitis A virus (HAV) is not necessary after routine HepA vaccination of infants, children or adults. Testing for the presence of anti-HAV antibody one month or more after completing the HepA vaccination series is recommended only for people whose future clinical management depends on knowing their immune status and for whom revaccination might be indicated, such as people living with HIV and other immunocompromised persons (such as transplant recipients and people vaccinated while receiving chemotherapy). In such individuals, if the results of postvaccination testing do not show an adequate immune response (10 mIU/mL or higher), revaccination with a complete series is recommended, followed by a second postvaccination serologic test. If that second test remains negative, no additional vaccination is recommended; however, the patient should be counseled on strategies to avoid exposure to HAV and the need for IG if an exposure occurs. If vaccination results in seroconversion, insufficient data are available to make recommendations concerning repeat testing, booster doses or revaccination.