Which of the following markers is NOT typically seen in a patient with vaccination immunity to Hepatitis B?

In someone who has been vaccinated against Hepatitis B, the presence of vaccination-induced immunity is primarily indicated by the detection of anti-HBs (antibody to hepatitis B surface antigen). This antibody indicates that the individual has developed immunity against the virus following vaccination.

Anti-HBc (antibody to hepatitis B core antigen) is typically associated with a past or current infection, not vaccination. The presence of HBsAg (hepatitis B surface antigen) would indicate an active Hepatitis B infection, which is contrary to what one would expect in a vaccinated individual. Similarly, Anti-HBe (antibody to hepatitis B e antigen) may also be present in individuals who have resolved an infection but does not signify vaccination immunity.

Therefore, HBsAg is the marker that would not be seen in a patient with vaccination immunity to Hepatitis B, as its presence indicates ongoing infection rather than protective immunity achieved through vaccination.