Ask the Experts: Nurse’s Anti-HBs Was Positive, Now Negative: Does She Need HepB Vaccine?

Welcome to Immunize.org’s Ask the Experts resources. This Ask the Experts question is presented by Immunize.org’s Kelly L. Moore, MD, MPH.
Question: I'm a nurse who received the HepB series more than 10 years ago and had a positive hepatitis B surface antibody (or, anti-HBs) follow-up titer (measured at 10 mIU/mL, or greater). At present, my titer is negative. What should I do now?
Answer: Do nothing. Data show that vaccine-induced anti-HBs levels might decline over time; however, immune memory (anamnestic anti-HBs response) remains intact following immunization. People with anti-HBs concentrations that decline to less than 10 mIU/mL are still protected against HBV infection. For healthcare professionals with normal immune status who have demonstrated adequate anti-HBs (at least 10 mIU/ mL) following full vaccination, booster doses of vaccine or periodic anti-HBs testing are not recommended.
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