Hepatitis B vaccine boosters for exposed workers

November 9, 2005

Mr. Gary E. Thomas

[Recipient address omitted]

Dear Mr. Thomas:

Thank you for your letter addressed to the Occupational Safety and Health Administration regarding the requirements of our Bloodborne Pathogens Standard, 29 CFR 1910.1030. Specifically, you had a question regarding whether your employer must provide another series of hepatitis vaccine shots if your blood test results show you no longer have a detectable titer. This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any question not delineated within your original correspondence.

According to the standard and our enforcement directive, Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens, (CPL 02-02-069), an employer's responsibility for providing the hepatitis B vaccination series is clear. Paragraph 1910.1030(f)(1)(i) of the standard states, "the employer shall make available the hepatitis B vaccine and vaccination series to all employees who have occupational exposure, and post-exposure follow-up to all employees who have had an exposure incident." This includes employer provision of, "the hepatitis B vaccine and vaccination series and post-exposure evaluation and follow-up, including prophylaxis... at no cost to the employee, ...at a reasonable time and place, and ...according to recommendations of the U.S. Public Health Service current at the time these evaluations and procedures take place."

Regarding your letter, neither a new series of shots nor a hepatitis B vaccination booster is currently required in the current U.S. Public Health Service (USPHS), Centers for Disease Control and Prevention's (CDC's) guidelines. Because the USPHS does not recommend routine booster doses of hepatitis B vaccine, they are not required by the Bloodborne Pathogens Standard at this time. The CDC has said that vaccine-induced antibodies to HBV decline gradually over time, and less than or equal to 60 percent of persons who initially respond to vaccination will lose detectable antibodies over 12 years. Studies among adults have demonstrated that, despite declining serum levels of antibody, vaccine-induced immunity continues to prevent clinical disease or detectable viremic HBV infection. Therefore, booster doses are not considered necessary. Periodic serologic testing to monitor antibody concentrations after completion of the three-dose series is not recommended. If a routine booster dose of hepatitis B vaccine is recommended by the USPHS at a future date, such booster doses must be made available at no cost to those eligible employees with occupational exposure.

Thank you for your interest in occupational safety and health. We hope you find this information helpful. Please be aware that OSHA's enforcement guidance contained in this response represents the views of OSHA at the time the letter was written based on the facts of an individual case, question, or scenario and is subject to periodic review and clarification, amplification, or correction. It could also be affected by subsequent rulemaking; past interpretations may no longer be applicable. In the future, should you wish to verify that the guidance provided herein remains current, you may consult OSHA's website at www.osha.gov. If you wish to obtain a hard copy of the standard or its directive, you may contact OSHA's Office of Publications at (202) 693-1888. If you have any further questions, please feel free to contact the Office of Health Enforcement at (202) 693-2190.

Sincerely,

Richard E. Fairfax, Director

Directorate of Enforcement Programs