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Occupational health · Hepatitis B

Hepatitis B vaccination for employees

If your risk assessment identifies exposure to blood or body fluids, hepatitis B vaccination is your obligation to provide and to fund. Here is what that involves.

Hepatitis B is the vaccination employers most often get wrong, usually in one of two directions. Some offer it to everyone as a perk, which wastes money on staff with no occupational exposure. Others assume it is the employee's own responsibility, which is a breach of duty where exposure is genuine.

Who actually needs it

The trigger is occupational exposure to blood or body fluids, identified through a COSHH risk assessment. In practice that commonly covers:

  • Healthcare and dental staff, including support and cleaning roles with sharps exposure.
  • Laboratory staff handling human samples.
  • Care workers where personal care involves foreseeable blood exposure.
  • Custodial staff, police and some enforcement roles.
  • Waste, sewage and sanitation workers, and those handling clinical waste.
  • Tattooists, piercers and some beauty practitioners.
  • Embalmers and mortuary staff.
  • Staff whose role includes first aid duties with realistic sharps or blood exposure.

An office worker who might one day give first aid is not automatically in scope. The assessment has to find exposure that cannot be adequately controlled by other means.

Who pays

Where the risk assessment indicates vaccination, the employer provides it free of charge. The cost cannot be passed to the employee, deducted from wages, or made conditional on them staying for a period. This follows from COSHH and from the general duty under the Health and Safety at Work etc. Act 1974 not to charge employees for measures taken to protect them.

Where vaccination is not indicated by the assessment, there is no obligation. Employers who want to offer it anyway can, but it is then a benefit, not a control measure.

The schedule

ScheduleTimingUsed when
Standard0, 1 and 6 monthsRoutine pre-exposure protection with time to plan
Accelerated0, 1 and 2 months, booster at 12Protection needed faster, e.g. a new starter entering an exposed role
Very rapid0, 7 and 21 days, booster at 12 monthsImminent exposure or travel-related urgency

We track each individual's position in the schedule and prompt before a dose falls out of window. New starters are picked up on catch-up rather than waiting for the next cohort.

Titre checking and non-responders

Completing the course is not the same as being protected. Around 5 to 10% of healthy adults do not mount an adequate antibody response to a primary course, and rates are higher with increasing age, smoking, obesity, immunosuppression and renal impairment.

For staff in exposure-prone roles, a post-vaccination anti-HBs titre taken one to two months after the final dose is the only way to establish immunity. Where the response is inadequate, the usual approach is a repeat course followed by retesting, and staff who remain non-responsive need to be identified so that they can be managed appropriately after any exposure incident.

If your file records doses but not titres, you do not actually know your coverage.

What we provide

  • On-site administration by GPhC-registered pharmacists at your premises.
  • Schedule tracking with proactive reminders per employee.
  • Arranged serology for post-vaccination antibody testing.
  • Immunity status reporting for your occupational health file, in aggregate.
  • Non-responders flagged for your occupational health adviser.
  • Combined hepatitis A and B where the assessment calls for both.

Hepatitis B sits alongside our wider occupational health vaccination service, and most clients run it in the same visit as their annual flu clinic.

Common questions

Do employers have to pay for the hepatitis B vaccine?

Yes, where a COSHH risk assessment identifies occupational exposure to blood or body fluids and vaccination is the appropriate control. The employer must provide it at no cost to the employee. It cannot be deducted from pay or made conditional on length of service. Where the assessment does not indicate vaccination, there is no legal obligation.

How many doses of hepatitis B vaccine are needed?

Three doses in the primary course. The standard schedule runs at 0, 1 and 6 months. Accelerated and very rapid schedules are available where protection is needed sooner, both with a booster at 12 months.

Do employees need a blood test afterwards?

For staff in exposure-prone roles, yes. An anti-HBs antibody titre one to two months after the final dose is the only way to confirm the course worked. Around 5 to 10% of adults do not respond adequately and need a repeat course.

Can you vaccinate at our premises?

Yes. We attend your site for each dose in the schedule, which removes the main reason courses go uncompleted.

What about new starters joining mid-programme?

We run them on catch-up against their own start date rather than holding them until the next cohort.

Is hepatitis B vaccination a legal requirement?

The legal requirement is on the employer to make vaccination available where the risk assessment indicates it. Receiving it remains voluntary for the employee. Where someone in a genuinely exposed role declines, that becomes a risk management question for you and your occupational health adviser.

Get a hepatitis B programme quoted

Tell us the roles involved and how many staff are in scope. We will come back with a schedule, a price and a view on whether titre checking is warranted.

Request a quote