What is the recommendation for a healthcare worker who has been tested for hepatitis B antibodies after three doses of vaccine and the lab test shows no antibodies?
Persons who do not respond to the first series of hepatitis B vaccine should complete a second three-dose vaccine series. The second vaccine series should be given on the usual 0, 1, 6-month schedule. A 0, 1, 4-month accelerated schedule may also be used. Revaccinated healthcare workers and others for whom postvaccination serologic testing is recommended should be retested at the completion of the second vaccine series. Fewer than 5% of persons receiving 6 doses of hepatitis B vaccine administered by the appropriate schedule in the deltoid muscle fail to develop detectable anti-HBs antibody. Some persons who are anti-HBs negative following 6 doses may have a low level of antibody that is not detected by routine serologic testing. One reason for persistent nonresponse to hepatitis B vaccine is that the person is chronically infected with HBV. Persons who fail to develop detectable anti-HBs after 6 doses should be tested for HBsAg. Persons who are found to be HBsAg-positive should be cou
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