American Board of Internal Medicine (ABIM) Certification Practice Exam

What is required for hepatitis B vaccination before solid organ transplantation?

1. Complete series if not already immune

2. Single dose only

3. No vaccination necessary

4. Half of the complete series

The correct answer is: Complete series if not already immune

Prior to solid organ transplantation, it is essential for patients to have adequate protection against hepatitis B, particularly because they may have an increased risk of infection due to their immunocompromised state following transplantation. The hepatitis B vaccination regimen consists of a complete series of vaccinations, usually comprising three doses administered over a specified time frame. If a patient has not previously been vaccinated or is not confirmed to be immune to hepatitis B at the time of evaluation for transplantation, the complete series is necessary to ensure they develop sufficient immunity. This immunization helps prevent complications from hepatitis B, which can significantly impact post-transplant outcomes. The other options do not provide the necessary level of protection. A single dose would not confer adequate immunity, while only receiving half of the complete series would leave the patient under-vaccinated. Declaring that no vaccination is necessary would disregard the potential risks associated with hepatitis B infection in transplant recipients. Therefore, the requirement for a complete vaccination series if not already immune is crucial for patient safety and successful surgical outcomes.