Hepatitis B

IMPORTANT: The documentation listed on this page must be uploaded to American Data Bank by June 30th to retain your place in the Fall nursing cohort. Failure to meet the deadlines and requirements of the onboarding process may jeopardize your place in the Fall nursing cohort.

Hepatitis B Vaccine

Documentation of immunity is required by vaccination and a positive QUANTITATIVE Hepatitis B surface antibody titer (HBsAb or anti-HBs) and must be uploaded to the American Data Bank website. To determine if your titer report is QUANTITATIVE, you will find reference ranges indicated on it, rather than just the words positive, negative or equivocal.

Please indicate “In Process” on your documentation if you are just starting the series, and forward documentation of further doses and titer results as they become available to American Data Bank. It is recommended that students complete their 3-dose series prior to patient (or body fluid) contact in clinical settings.

Documentation required for each dose must include (1) the date of vaccination and (2) the name of the healthcare provider.

Documentation required for the titer must be (1) a type written lab report which includes (a) the collection date,      (b) the titer reference range, (c) the titer result, and (d) the name of the labNo handwritten reports will be accepted

Initial series

  • The vaccination is given in a 3 dose series. Upload documented proof of each dose to American Data Bank.
    • There must be at least one month between dose one and two and
    • There must be at least five months between dose two and three
  • 6 – 8 weeks after the last dose in the series a QUANTITATIVE surface antibody titer (HBsAb or anti-HBs) is required. (You will see reference ranges indicated on a lab report with quantitative results.)
    • If you have a “Positive Titer” – you are done. Upload your results to American Data Bank.
    • If your titer is “Negative” or “Equivocal” you are required to follow these additional steps:
      • Upload your results to American Data Bank.
      • Sign the Hepatitis B Waiver 
        • Note: you cannot participate in the clinical setting without a positive  Hepatitis B titer or completing the Hepatitis B Waiver and uploading it to American Data Bank. Specific healthcare institutions may not accept a declination/waiver form.
      • Move on to the section of this page titled, “What to do after a negative or equivocal titer.”
  • Hepatitis B Vaccine: CDC Information Sheet

What to do after a negative or equivocal titer

  • A negative or equivocal titer after the complete Hepatitis B series (doses 1 -3) requires you to choose from the following two options.
    • Repeat the series (consisting of doses number 4, 5, & 6) and repeat the QUANTITATIVE surface antibody titer (HBsAb or anti-HBs) 6 to 8 weeks later. OR
    • Obtain a challenge dose (number 4) and repeat the QUANTITATIVE surface antibody titer (HBsAb or anti-HBs) 6 to 8 weeks later.
  • If your QUANTITATIVE surface antibody titer is still negative after two Hepatitis B immunization series you are considered a non-responder. If you find yourself in this situation we encourage you to have a discussion with your healthcare provider regarding Hepatitis B exposure risk as a nurse. 
  • A negative or equivocal titer without documentation of the vaccination series requires you to receive the initial series and titer as described in the section above titled “Initial Series”
    • You are required to receive the initial series and titer.

What to do if you don’t have documentation of the vaccination series

  • A series of QUANTITATIVE surface antibody titers (serologic testing) is required to determine if you are immune due to (1) a previous natural infection or (2) currently/chronically infected with the virus. (You will see reference ranges indicated on a lab report with quantitative results.)
    • anti-HBs or HBsAb (Hepatitis B surface antibody) – Immune to Hepatitis B due to immunization or natural infection.
    • anti-HBc or HBcAb (Hepatitis B core antibody) – currently or chronically infected.

Click here for a link to the CDC Serologic Testing page for Hepatitis B.

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