A hepatitis B surface antibody (anti-HBs) titer of 10 mIU/mL or more after your vaccine series means you're considered immune. Below 10 doesn't mean you did anything wrong. CDC has a set path for healthcare personnel, and programs follow it. (source)
The CDC steps
- Titer below 10 after your first series: get revaccinated. A second complete series, then a titer 1–2 months after the last dose, is usually most practical. (source)
- Or one extra dose first: a single additional dose with a titer 1–2 months later, finishing the second series only if you're still below 10. Heplisav-B may be used for revaccination. (source)
- Still below 10 after revaccination: you should be tested for HBsAg (to rule out infection). If negative, you're a non-responder, considered susceptible, and would get HBIG after any known or likely exposure. (source)
- No more series after that: more than two complete series is generally not recommended. (source)
Vaccinated years ago with no titer on record? CDC describes a single challenge dose to check for immune memory; 10 or more afterward counts as protected. (source) CDC also says no specific work restrictions are recommended for vaccine non-responders. (source)
What programs ask you to document
- University of West Georgia: two completed series and two negative follow-up titers, with a provider signature, to declare non-responder status. (source)
- UCLA Nursing: after a negative titer, one challenge dose and a repeat titer 30 days later; still negative may mean more evaluation, including HBsAg testing. (source)
In the Drug Free Schools portal
Programs can add another way to meet a requirement, so a non-responder pathway (series records, titers and a provider's letter) can count toward hepatitis B instead of leaving a student stuck. Every upload is reviewed within 24 hours. See also titer testing explained.
Sources
- CDC/ACIP, Prevention of Hepatitis B Virus Infection, MMWR 2018;67(RR-1)
- CDC, Heplisav-B recommendations, MMWR 2018;67(15)
- CDC guidance for evaluating health-care personnel for HBV protection, MMWR 2013;62(RR-10)
- University of West Georgia hepatitis B non-responder form
- UCLA nursing student immunization requirements
General information from public federal documents and published school policies as of September 2026, not medical or legal advice. Your program and clinical sites set the rules that apply to you.
Frequently asked questions
What titer level means I'm immune to hepatitis B?
An anti-HBs result of 10 mIU/mL or higher after vaccination is considered immune, according to CDC.
My titer is negative. Do I restart the whole series?
CDC says either a second complete series with a titer 1–2 months after the last dose, or one extra dose with a titer 1–2 months later and finishing the series only if still below 10.
Can a hepatitis B non-responder still do clinicals?
CDC recommends no specific work restrictions for non-responders; they're considered susceptible and get HBIG after an exposure. Your program and clinical sites decide what documentation they need.
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