A Cross-Sectional Study on Anti Hepatitis B Immune Status in Vaccinated Healthcare Workers in the West Pomeranian Region of Poland
Hepatitis Monthly: ,
12 (3); 185-189 Article Type: Research Article
January 20, 2012
March 4, 2012
M. A Cross-Sectional Study on Anti Hepatitis B Immune Status in Vaccinated Healthcare Workers in the West Pomeranian Region of Poland ,
Online ahead of Print
Background: Hepatitis B vaccination, recommended for medical staff, has a non-response rate of 5% to 32%. In Poland, there is no standardized postvaccination protocol to verify immunity. Objectives: To determine the fraction of those who have been vaccinated against HBV (with a complete course followed/not followed by a booster) but not checked for serological evidence of hepatitis B immunity and to detect anti-HBs levels in this group by anonymous cross-sectional sero-survey. Patients and Methods: Surgical/gynecological staff from 16 randomly selected hospitals in West Pomerania, Poland, were surveyed between July 2010-January 2011. EIA system version 3.0 was used to detect anti-HBs. Results: Of 488 participants (439 females, median age 42 years) who were previously vaccinated (1-21 years ago), anti-HBs status was not determined after HBV vaccination in 361 individuals (74.0%; 95% CI: 69.9-77.7%), 5% (18/361) of whom had an anti-HBs titer of 0.0 mIU/ml (12/18 who were given booster doses developed anti-HBs > 10 mIU/ml) and 7.2% (26/361) of whom had an anti-HBs titer of 0.1-10 mIU/ml. The multivariate logistic regression model revealed that working in a teaching hospital was associated with lower odds of not being checked for anti-HBs after HBV vaccination (OR 0.22, 95% CI: 0.14-0.35; P = 0.0001). Conclusions: The lack of a strict post-HBV vaccination policy to confirm immunity results in the majority of surgical/gynecological staff not checking their anti-HBs levels after HBV immunization. It is unknown whether the absence of current serological evidence of hepatitis B immunity can be attributed to non-response, the waning of vaccine-induced immunity, or preserved anamnestic response. The lack of a booster vaccination response in a fraction of subjects suggests that they are non-responders. Strict post-vaccination testing to document immunity remains the key practice to detect non-responders among medical staff.
The study discusses strict post HBV vaccination testing to document immunity as a key practice to detect non-responders among medical staff and points at the possible consequences of the lack of such a policy. Issues discussed in this article can be useful for those at risk of occupational HBV infection, specialists in the field of occupational medicine, infectious diseases and health policy makers. Implication for health policy/practice/research/medical education:
Please cite this paper as: Ganczak M. A Cross-Sectional Study on Anti Hepatitis B Immune Status in Vaccinated Healthcare Workers in the West Pomeranian Region of Poland. Hepat Mon. 2012;12(3): 185-9. DOI: 10.5812/hepatmon.850
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