HCA | Hepatitis B Vaccine or Titer Declination

This credential can be satisfied 3 ways: documentation of a completed hepatitis B vaccine series, a titer showing immunity, or a signed declination. Each one records a decision, and a decision on file is what facilities need before you work. It sits with your other nursing credentials.

Why do facilities ask for this?

Because of what the work involves. Hepatitis B is bloodborne, and clinicians handling needles, blood, or other potentially infectious material have occupational exposure to it. The federal bloodborne pathogens standard requires the vaccine to be offered to workers with that exposure and requires a signed declination in specific terms when someone chooses not to receive it. That is where the form comes from.

What are the 3 routes?

Whichever fits your situation.

  • Documentation of a completed vaccine series
  • A titer result showing immunity to hepatitis B
  • A signed declination form

A titer is often the cleanest route for clinicians vaccinated years ago, since it answers the question directly rather than depending on records you may no longer have.

What does a titer show?

It measures hepatitis B surface antibody in your blood. A result at or above the accepted threshold indicates immunity, and that number is what facilities look at. Clinicians vaccinated in childhood sometimes test below it, which does not necessarily mean the vaccine failed. The usual next step is repeating the series and retesting, so discuss a low result with a provider rather than drawing conclusions from the number alone.

What does declining actually mean?

That you made a documented choice rather than closing a door. The standard declination language preserves your ability to receive the vaccine later if you change your mind. Signing it satisfies the credential wherever the requirement is written to allow it. Leaving the item untouched does not, which is the distinction that matters.

Adding it to your profile

Upload whichever of the 3 documents applies to you.

  1. Tap Menu in the top left of the Nursa app.
  2. Select Profile.
  3. Scroll to the Credentials section.
  4. Tap Add your Credential.
  5. Upload your document as a PDF, WORD, JPG, or PNG.

Sign up as a clinician and close this one out with whichever route suits you.

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