From the Guidelines
For a patient with a low Hepatitis B Surface Antibody (Anti-HBs) level of <3.5 mIU/mL, a booster dose of the Hepatitis B vaccine is recommended, as this level indicates inadequate immunity. The standard adult booster is a single dose of 20 mcg (1.0 mL) administered intramuscularly in the deltoid muscle, as indicated in the study by 1. After receiving the booster, the patient should have their Anti-HBs level rechecked 1-2 months later to confirm an adequate immune response (levels ≥10 mIU/mL), as suggested by 1 and 1. If the antibody level remains below 10 mIU/mL after the booster, a complete revaccination series may be necessary, consisting of three doses given at 0,1, and 6 months, as recommended by 1 and 1. Some patients, particularly those who are immunocompromised, older, or have certain health conditions, may have a diminished response to the vaccine and might require higher dosages or additional doses, as noted in 1 and 1. The booster is necessary because adequate Anti-HBs levels (≥10 mIU/mL) are crucial for protection against Hepatitis B infection, as emphasized by 1, 1, and 1. When antibody levels fall below this threshold, the immune system may not mount a sufficient response if exposed to the virus, potentially leading to infection. Key considerations for the booster dose include:
- Administering the booster dose as soon as possible after determining the low Anti-HBs level
- Using a single-antigen HepB vaccine for the booster dose, as recommended by 1
- Monitoring the patient's Anti-HBs level after the booster dose to ensure an adequate immune response
- Considering a complete revaccination series if the patient's Anti-HBs level remains below 10 mIU/mL after the booster dose.
From the Research
Hepatitis B Surface Antibody (Anti-HBs) Level and Immunity
- A low Hepatitis B Surface Antibody (Anti-HBs) level of <3.5 mIU/mL indicates immunity is inconsistent 2, 3, 4, 5, 6.
- According to various studies, a level of anti-HBs greater than 10 mIU/mL is considered consistent with immunity 2, 3, 4, 5, 6.
- Patients with anti-HBs levels between 0.0 and 10.0 mIU/mL may not have sufficient immunity against Hepatitis B 2, 3, 4, 5, 6.
Recommendations for Patients with Low Anti-HBs Levels
- For patients with low anti-HBs levels, revaccination or booster shots may be necessary to achieve sufficient immunity 3, 4, 5, 6.
- The response to vaccination can be influenced by factors such as age, with younger recipients having a greater chance of developing sufficient anti-HBs levels 2.
- Regular monitoring of anti-HBs levels is recommended to determine the need for revaccination or booster shots 4, 5, 6.
Vaccination and Immunity
- Hepatitis B vaccination can provide long-term immunity against the virus, with anti-HBs levels remaining elevated for more than 10 years in some cases 6.
- The vaccination scheme typically consists of three doses, and a successful vaccination is indicated by an anti-HBs titer higher than 100 IU/L 6.
- Excellent immune memory is formed after successful vaccination, providing protection against Hepatitis B for an extended period 6.