Useful vaccine serology (hepatitis B in healthcare workers, chickenpox, hepatitis A, catch-up)
BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.
Hepatitis B: healthcare workers and students (proof of immunity)
- Not needed if the person has a result, even an old one, of anti-HBs antibodies > 100 IU/L: they are immune.
Laboratory tests
- Anti-HBc antibodies and anti-HBs antibodies (titrated)
- HBV DNA (if anti-HBc antibodies detected)if neededAnti-HBc antibodies detected: the algorithm asks for HBsAg (included in the serology) and HBV DNA [2].
1 to 2 months after each additional injection or after the end of the schedule
Do not order
Hepatitis B: check after vaccination (outside occupational requirement)
1 to 2 months after the last dose
- Anti-HBs antibodies
- HBsAg and anti-HBs antibodies (child born to an HBsAg-positive mother, from 9 months)if neededNewborn of an HBsAg-carrier mother: check in all cases (HBsAg and anti-HBs) from 9 months, if possible 1 to 4 months after the last dose [2].
- HBsAg and anti-HBc antibodies (if anti-HBs < 10 IU/L after a complete schedule)if neededTitre < 10 IU/L after a complete schedule: before concluding non-response, the HCSP (2014), the United Kingdom and Germany exclude chronic infection by HBsAg and anti-HBc [4,6,7]. The single marker is billed as the full serology (procedure 4500) [3].
Do not order
- Anti-HBs measurement after routine vaccination of an infant, child or adolescent without a risk factor: the schedule does not provide for it and does not recommend routine boosters [2].
Chickenpox: before vaccinating an adolescent or adult
Laboratory tests
- Varicella serology (anti-VZV IgG)
Also consider
- Pregnant woman exposed to varicella? See the page “Pregnancy: exposure (varicella, measles, parvovirus B19, CMV) or serology to interpret”.
Hepatitis A: before vaccinating
Laboratory tests
- Hepatitis A serology: IgG (past immunity)
Catch-up: unknown or incomplete vaccination status
Before catch-up vaccination
- Hepatitis B serology: HBsAg, anti-HBs, anti-HBcif neededExposure to a risk of hepatitis B, or origin from a country of intermediate or high endemicity [2].
4 to 8 weeks after a vaccine dose
- Tetanus antibodies (after a dose of a vaccine containing the tetanus component)
- Anti-HBs antibodies (after a dose of hepatitis B vaccine)if neededIf a dose of hepatitis B vaccine was given as part of catch-up [2]; apart from the check at the end of the schedule, the single marker is billed as the full serology (4500) [3].
Also consider
Do not order
- Measles, mumps, rubella and diphtheria serology before catch-up vaccination, and tetanus serology before vaccination: not recommended [2].
- Measles or rubella serology before MMR vaccination (status unknown, health professionals born before 1980): vaccinate without serological check, there is no risk in vaccinating a person who is already immune [2].
- Rubella serology before or after the MMR dose in a woman born before 1980 planning a pregnancy: unnecessary [2].
Sources (14)
- Santé publique France. Données de couverture vaccinale hépatite B par groupe d'âge (sources : DREES, certificats de santé du 24e mois ; enquêtes en milieu scolaire). Page en ligne consultée le 24/10/2026.
- Ministère chargé de la santé. Calendrier des vaccinations et recommandations vaccinales 2025 (avril 2025) : chapitres 2.8 (hépatite A), 2.9 (hépatite B), 2.18 (rougeole, oreillons, rubéole), 2.20 (varicelle), 2.23 (statut vaccinal inconnu ou incomplet) et tableau 4.8 (algorithme de contrôle de l’immunisation contre l’hépatite B des professionnels de santé, d’après l’arrêté du 2 août 2013 et l’instruction DGS du 21 janvier 2014).
- Caisse nationale de l’assurance maladie. Nomenclature des actes de biologie médicale (NABM), version 105 : actes 4500 et 4714 (hépatite B), 4120 (ADN du VHB), 1779 (anticorps anti-VZV), 1736 (IgG anti-VHA), 1332 (tétanos).
- UK Health Security Agency. Immunisation against infectious disease (Green Book), chapitre 18 : Hepatitis B. Version du 5 février 2026.
- Schillie S, Vellozzi C, Reingold A, et al. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2018;67(1):1-31.
- Robert Koch-Institut (Allemagne). Recommendations of the Standing Committee on Vaccination (STIKO) at the Robert Koch Institute – 2026. Epidemiologisches Bulletin 4/2026, 22 janvier 2026 (version anglaise).
- Haut Conseil de la santé publique. Avis relatif à la problématique des non-répondeurs dans le cadre de la vaccination contre l'hépatite B. 7 novembre 2014.
- UK Health Security Agency. Green Book, chapitre Varicella. Version du 7 avril 2026.
- Nelson NP, Weng MK, Hofmeister MG, et al. Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020. MMWR Recomm Rep. 2020;69(5):1-38.
- UK Health Security Agency. Green Book, chapitre Hepatitis A. Version du 24 août 2026.
- Code du travail, article D4152-3 (créé par le décret n° 2008-244 du 7 mars 2008), version en vigueur.
- UK Health Security Agency. Vaccination of individuals with uncertain or incomplete immunisation status: supporting guidance. Août 2026.
- UK Health Security Agency. Green Book, chapitre 30 : Tetanus. Version du 2 juin 2025.
- UK Health Security Agency. Green Book, chapitre Measles. Version du 2 avril 2026.