What is the follow-up strategy for Hep B vaccination if the initial response is less than 10mIU/mL?

When the initial response to the Hepatitis B vaccination is less than 10 mIU/mL, it indicates that the individual has not achieved adequate immunity from the vaccine. In this situation, the appropriate follow-up strategy is to test for Hepatitis B infection. This is crucial because a low antibody response could suggest either an inability to mount an immune response to the vaccine or a pre-existing infection with Hepatitis B, which may have gone undetected.

Testing for Hepatitis B infection helps determine whether the person is currently infected or if they are a chronic carrier. If the test shows that the individual is indeed infected with Hepatitis B, this information can guide appropriate management and treatment options.

Administering antivirals would not be an immediate response to a low vaccine antibody level; these are reserved for individuals who are already infected. Similarly, rechecking antibody levels after just one week may not provide useful information; typically, a longer time frame is needed for an immune response to develop post-vaccination. Vitamin supplements have no role in addressing inadequate vaccine response or Hepatitis B infection. Thus, testing for Hepatitis B infection is the essential next step in this scenario.