In a needlestick exposure where the source patient is immune by vaccination and the healthcare worker is susceptible, what information should be shared and what follow-up action is recommended?

• A. The patient is immune by means of vaccination; the health care worker is susceptible and should be offered the HBV vaccine.
• B. The patient is immune by means of vaccination; the health care worker is immune and needs no follow-up.
• C. The patient is acutely infected; the health care worker should be given HBIG.
• D. The patient is susceptible; the health care worker should be vaccinated later if needed.

Answer: (A)

Post-exposure management for hepatitis B hinges on the source’s infection status and the exposed worker’s immunity. When the source patient is immune due to vaccination, the risk of HBV transmission is very low. The important step is to inform the exposed healthcare worker that the source is vaccinated and immune, while the worker is susceptible. Because the worker has no immunity, they should be offered hepatitis B vaccination as post-exposure prophylaxis and begin the three-dose vaccine series as soon as possible, with follow-up serology to confirm protection after completing vaccination. HBIG is not indicated in this scenario since the source is not acutely infectious and the worker is susceptible but vaccination provides protection.