Do you recommend re-vaccination in immunosuppressed patients who completed hepatitis B vaccine series but are found to have undetectable or low surface antibody titers?

In immunosuppressed patients who have completed the hepatitis B vaccine series but are found to have undetectable or low hepatitis B surface antibody (anti-HBs) titers, do you recommend re-vaccination?

• Yes, I always re-vaccinate regardless of prior vaccine completion
• No, I rely on completed vaccine series regardless of titer
• Depends on type and intensity of immunosuppression
• Refer to Allergy/Immunology for immunodeficiency workup