Hepatitis B is a serious disease caused by a virus that attacks the liver. The virus, which is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death.
Hepatitis B vaccine is available for all age groups. The hepatitis B vaccine is recommended for all infants, all children or adolescents younger than 19 years of age who have not been vaccinated, all adults aged 19 through 59 years, and adults aged 60 years or older with risk factors for hepatitis B infection. Adults who are 60 years or older without known risk factors for hepatitis B may also receive a hepatitis B vaccine.
It's strongly advised for workers whose job duties may expose them to infectious agents, such as blood, body fluids, or tissues from humans or non-human primates, to receive the Hepatitis B (HBV) vaccine. This recommendation applies to laboratory personnel, healthcare professionals, and custodial staff. While employees can choose to decline the HBV vaccine, those who do must fill out a Hepatitis B Vaccine Declination Form for their employment records.
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Hepatitis B Vaccination and Testing Guidance
Hepatitis B Vaccination for Pre-Exposure Protection
To ensure effective pre-exposure protection against Hepatitis B virus (HBV), a series of three injections is recommended. The schedule includes an initial dose, followed by doses at 1–2 months and 4–6 months. This protocol helps ensure the development of sufficient antibodies to protect against HBV.
In addition, we now offer the Heplisav-B® (HepB-CpG) Vaccine, which requires only a two-dose series. These doses are administered at least 4 weeks apart and are available at our third-party Occupational Health Clinic.Blood Testing for Hepatitis B Diagnosis
Hepatitis B can be diagnosed through a simple blood test, which can be done at your doctor’s office or local health clinic. The test results help determine if you:- Are currently infected with Hepatitis B,
- Are protected (through vaccination or recovery from a past infection), or
- Are still at risk of infection.
It’s important to request the “Hepatitis B Panel”, which includes three components but requires only one blood sample. This panel provides a full picture of your status, including whether you are:
- Infected with HBV,
- Protected from HBV, or
- At risk for HBV infection.
Always ask for a copy of your blood test results to fully understand your health status.
Recommendations Based on Hepatitis B Titer Results
If a Hepatitis B Titer (anti-HBs titer) indicates that you are non-reactive, this means your antibody levels are below the protective threshold, and you are not immune to HBV.This could occur due to:
- Lack of prior exposure to the virus,
- Incomplete or ineffective vaccination, or
- Waning immunity over time.
Next Steps Based on Titer Results:
If Unvaccinated:
- Begin the Hepatitis B vaccination series (3 doses over 6 months or the 2-dose Heplisav-B series if applicable).
If Previously Vaccinated:
- Administer a Hepatitis B booster dose.
- Retest the titer 1–2 months after the booster to confirm immunity.
- If still non-reactive, complete a second series of the vaccine (typically 3 doses) and retest.
If Non-Responsive to Vaccination:
- If non-reactive after completing two full vaccine series, the individual is considered a “non-responder.” In such cases:
- Provide counseling on their risk of HBV infection.
- Encourage preventative measures, such as safe needle practices and avoiding blood exposure.
- Conduct further testing for chronic HBV infection with HBsAg (Hepatitis B Surface Antigen) to rule out undetected active infection.
Occupational Health Considerations:
- For individuals in healthcare or other high-risk environments, follow workplace policies for non-immune individuals. This includes post-exposure prophylaxis in the event of HBV exposure.
Hepatitis B Testing in the U.S.
The Centers for Disease Control and Prevention (CDC) recommends that all adults aged 18 and older be screened for Hepatitis B at least once in their lifetime.
Testing is widely available through various providers:- Primary care clinicians can test for Hepatitis B.
- The Hep B United campaign provides free or low-cost testing across the U.S. Visit Hep B United Local Campaigns for more information.
- Use the CDC’s database to find testing centers near you by searching at Get Tested.
Taking proactive steps to understand your immunity or infection status is essential for protecting your health and preventing the spread of Hepatitis B.
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Hepatitis B Vaccine Guidance Document
Environmental Health and Safety (EH&S) ensures that all employees who may encounter occupational exposure to bloodborne pathogens are provided with funding for the Hepatitis B vaccine upon request.
After the vaccination series, healthcare workers should undergo serologic testing (Hep B Titer) to assess antibody levels.
All individuals must complete the Bloodborne Pathogen Online course before receiving the HBV vaccine, which can be accessed through the UC Learning Center.
To schedule a Hepatitis B vaccine series or titer test, please contact the Occupational Health Coordinator by emailing ehsocchealth@ucr.edu or calling (951) 827-5528.
- Bloodborne Pathogens Awareness (For Non-Research Personnel)
- Hepatitis Resource Information