A healthcare worker sustains a needlestick injury from a patient who is HBsAg positive. The worker completed the 3-dose hepatitis B vaccine series 5 years ago but never checked anti-HBs levels. What is the MOST appropriate management?
- A Hepatitis B immunoglobulin (HBIG) only
- B Booster dose of hepatitis B vaccine only
- C Test for anti-HBs; if >10 mIU/mL, no further action ✓
- D HBIG + hepatitis B vaccine booster
Correct answer: C. Test for anti-HBs; if >10 mIU/mL, no further action
Explanation
For a previously vaccinated individual with unknown anti-HBs status, the correct approach is to test anti-HBs levels immediately. If anti-HBs is >10 mIU/mL, the person is considered protected and no further action is needed. If <10 mIU/mL, a booster dose of hepatitis B vaccine should be given. HBIG is indicated for unvaccinated individuals or those known to be non-responders after vaccination. Testing first avoids unnecessary HBIG administration in responders.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.