- OSHA Healthcare Advisor - http://blogs.hcpro.com/osha -

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

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 [1].

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