A 32-year-old healthcare worker receives post-exposure prophylaxis (PEP) after a needlestick injury from an HBsAg-positive patient. She was previously vaccinated with 3-dose HBV vaccine series but never had a post-vaccination anti-HBs titre checked. The recommended management is:
- A Test anti-HBs immediately; if <10 mIU/mL give HBIG + HBV vaccine booster dose ✓
- B No action needed — prior complete vaccination series provides lifelong protection
- C Immediately administer HBIG only
- D Administer HBIG + full 3-dose HBV vaccine series from scratch
Correct answer: A. Test anti-HBs immediately; if <10 mIU/mL give HBIG + HBV vaccine booster dose
Explanation
Per CDC and ACIP guidelines, for a healthcare worker with prior complete 3-dose HBV vaccination but unknown anti-HBs status: test anti-HBs immediately. If anti-HBs ≥10 mIU/mL — adequate protection, no PEP needed. If anti-HBs <10 mIU/mL (non-responder) — administer HBIG (0.06 mL/kg IM) plus one HBV vaccine booster dose; retest anti-HBs in 1–2 months. Full 3-dose restart is only needed for unvaccinated individuals or documented non-responders after 6 doses.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.