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Technically Speaking
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November 2016
Technically Speaking
Monthly Column by Deborah Wexler, MD
Deborah Wexler MD
Technically Speaking is a monthly column written by IAC’s Executive Director Deborah Wexler, MD. The column is featured in The Children's Hospital of Philadelphia Vaccine Education Center’s (VEC's) monthly e-newsletter for healthcare professionals. Technically Speaking columns cover practical topics in immunization delivery such as needle length, vaccine administration, cold chain, and immunization schedules.
Check out a recent issue of Vaccine Update for Healthcare Providers. The VEC e-newsletter keeps providers up to date on vaccine-related issues and includes reviews of recently published journal articles, media recaps, announcements about new resources, and a regularly updated calendar of events.
TECHNICALLY SPEAKING
Who Needs Hepatitis B Serologic Testing before or after Vaccination?
Published November 2016
In the August and October Technically Speaking columns, I reviewed CDC’s recommendations for hepatitis B vaccination of infants, children, and teens, as well as adults.

Pre- and/or post-vaccination serologic testing is recommended for some people who are candidates for vaccination.
 

Pre-vaccination serologic testing

Pre-vaccination testing should be considered for people who are at high risk for past or current hepatitis B virus (HBV) infection who would not benefit from hepatitis B vaccine if found to be currently infected or already immune.

CDC recommends pre-vaccination testing for the following groups:

  • All foreign-born people (including immigrants, refugees, asylum seekers, and internationally adopted children) born in Africa, Asia, the Pacific Islands, and other regions with high endemicity of HBV infection (HBsAg prevalence of 8 percent or higher)
  • Household, sex, and needle-sharing contacts of HBsAg-positive people
  • HIV-infected people

In addition, testing might be cost effective in populations with a prevalence of HBV infection of 20 percent or higher.

Consult the ACIP recommendations below for details about populations at risk and which tests should be ordered. People with chronic HBV infection should be promptly referred to someone experienced in the management of chronic infection.

Note: Serologic testing should not be a barrier to vaccination, and both can be undertaken during a single office visit. The first vaccine dose should be administered after collection of the blood sample for serologic testing. Vaccinating a person who is infected or immune will do no harm.

Post-vaccination serologic testing

Post-vaccination testing is recommended for people whose subsequent clinical management depends on knowledge of their immune status, and includes the following groups:

  • Healthcare workers and public safety workers at high risk for continued percutaneous or mucosal exposure to blood or body fluids (e.g., acupuncturists, dentists, dental hygienists and assistants, emergency medical technicians, first responders, laboratory technologists/technicians, nurses, nurse practitioners, phlebotomists, physicians, physician assistants, medical assistants, and students entering these professions)
  • Chronic hemodialysis patients
  • HIV-infected persons and other immunocompromised persons
  • Sex partners of HBsAg-positive persons
  • Needle-sharing partners of HBsAg-positive persons

CDC references

IAC-related resources

2016 ISSUES >> view all
NOVEMBER 2016
Who Needs Hepatitis B Serologic Testing before or after Vaccination?
OCTOBER 2016
Hepatitis B Vaccination for Adults — Who Needs It and When?
SEPTEMBER 2016
What’s New in the Influenza Vaccination Recommendations for the 2016-17 Season?
AUGUST 2016
Let's Review — Routine Hepatitis B Vaccination Schedules For Infants, Children and Teens
JULY 2016
How You Can Help Overcome Low Vaccination Rates among Adults
JUNE 2016
Give a Strong Recommendation for HPV Vaccine for All Preteens and Young Adults
MAY 2016
Just Released! IAC's May Edition of Needle Tips
APRIL 2016
CDC Experts Answer 1,000+ Vaccine-related Questions at Immunize.org
MARCH 2016
Using Standing Orders to Vaccinate Increases Coverage Rates and Protects Patients
FEBRUARY 2016
Just Released! CDC's Official Immunization Schedules for 0- to 18-year-olds and for Adults
JANUARY 2016
Remember to Routinely Administer TWO Pneumococcal Vaccines One Year Apart to Healthy Adults Age 65 and Older
 
This page was updated on December 9, 2016.
 
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This website is supported in part by a cooperative agreement from the National Center for Immunization and Respiratory Diseases (Grant No. 6NH23IP22550) at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA. The website content is the sole responsibility of IAC and does not necessarily represent the official views of CDC.