Ask the expert: Refusing the hepatitis B post-vaccination titer

By: June 26th, 2012 Email This Post Print This Post

Q: If an employee agrees to the hepatitis B the vaccination but fails to follow through on the titer one to two months after the series, what should I do for OSHA compliance?

A: There is no regulation that says you can force an employee to complete the titer, even though a titer one to two months after the third shot in the vaccination series is essential to confirm immunity.

You should document that you have explained to the employee why the titer is needed and that in the absence of post-vaccination testing you would be required to manage any exposure to hepatitis B as vaccinated but non-responsive, as explained in Table 3 of Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis.

This category of immunity requires different and more involved post-exposure management than the vaccinated and responsive category.


By Debra Anthony on June 26th, 2012 at 10:33 am

Is the employer required to pay for the post Hep B series titer?

By David LaHoda on June 28th, 2012 at 11:57 am

Yes. Section 1910.1030(f)(1)(ii)(A), “Made available at no cost to the employee;” would apply to the titer.

Good afternoon,

Q: Do the laws and regulations allow injured employees care that include: examination, treatment plan (medications,etc) and work status to be discussed between employer and medical provider or is there only particular information that can be discussed/released to the employer? Also must a consent to release and discuss any information pertaining to their medical care of their injury be signed prior to discussing those particular items with the employer? Would this also apply to all occupational health services that include: post offer physical, fit for duty, urine drug screens, etc.

Thank you.
Thank you,


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