Vaccination against hepatitis B in health care workers
Section snippets
Epidemiology of hepatitis B virus infection in health care workers
Health care workers represent one of the most important risk groups for hepatitis B virus (HBV) infection. HBV is transmitted via contact with infected blood or body fluids. The high contagiousness of the virus, coupled with its ability to resist even for months in the external environment under appropriate conditions explain why such a large number of subjects working in a health care setting traditionally showed evidence of past or chronic infection. Of course, prevalence of HBV markers in
Legislation
A general framework Directive of the European Community regarding risks in the workplace was issued in 1989 (89/291/EEC) and came into force at the beginning of 1993. The Biological Agents Directive (90/679/EEC) was more specifically related to hepatitis B, since it covered the general protection of workers from risks related to exposure to biological agents at work. Despite indicating that effective vaccines should be made available to exposed workers, the Directive, however, left some open
Hepatitis B vaccination: target groups and procedures
Deciding who is at occupational risk of hepatitis B is certainly not easy. Activities performed at work, rather than job title, should be the basis of risk assessment. In this view, all workers whose activities imply a regular physical contact with patients and/or their blood or biological fluids (particularly semen, cerebrospinal, vaginal, synovial, pleural, pericardial, peritoneal and amniotic fluids, and other body fluids contaminated with blood) should be immunised against HBV. The list of
Management of non-responders, need for booster doses and post-exposure prophylaxis
A level of anti-HBs ≥10 mIU/ml is conventionally considered as being protective, although some researchers prefer arbitrary titres of ≥100 mIU/ml to ensure protection against HBV infection [17]. Several factors have been shown to influence the rate of response to a complete course of immunisation against hepatitis B. Age is probably the most important one. In a recent study on about 2000 vaccinated health care workers, univariate analysis showed a relative risk for non-response among subjects
Coverage
Coverage with hepatitis B vaccination in health care workers is still far from optimal in most industrialised countries. A survey performed in Italy in 1996 on >3000 health care workers of public hospitals showed an average vaccination coverage of 65%, with a record low of 44% in a southern Italian city. In logistic regression analysis, younger age and lower years of employment were independent predictors of vaccine acceptance among health care workers [28]. Another study among health care
Conclusions
Universal programmes of hepatitis B vaccination in infants and adolescent are expected to decrease progressively the number of HBV carriers in the assisted population of countries that already introduced routine immunisation. However, since such preventive programmes will make HBV transmission to health care workers a rare event only in the long-term, it is necessary to continue and increase our efforts to vaccinate all subjects whose activity poses them at risk of infection. Presently,
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Cited by (60)
An update after 16 years of hepatitis B vaccination in South Africa
2012, VaccineCitation Excerpt :Organisations such as the Viral Hepatitis Prevention Board endorsed this policy, and extended the recommendation to include vaccination of students in their early years of study in the health professions [62]. Similarly, the United States requires that employers offer free vaccination to at-risk HCWs, as stipulated in the Occupational Safety and Health Administration Blood-borne Pathogen Standard [59,63]. When post-vaccination testing shows a sufficient immune response, no booster doses are needed even after subsequent loss of anti-HBs [34,36].
Medical fitness to work in healthcare workers with chronic hepatitis B
2012, Archives des Maladies Professionnelles et de l'EnvironnementHepatitis B vaccination coverage in healthcare workers in Gauteng Province, South Africa
2011, VaccineCitation Excerpt :In Europe and the United States, there are policies aimed at preventing occupationally acquired and nosocomial transmission of HBV. For example, the European Union (EU) requires all employers to provide information and vaccination to at-risk HCWs [14–16], and it is official policy in many EU countries to vaccinate all newly enrolled HCWs for HBV [17]. Organisations such as the Viral Hepatitis Prevention Board (VHPB) endorsed this policy, and extended the recommendation to include vaccination of students in their early years of study in the health professions [18].
Prevalence and Risk Factors of Hepatitis B Virus Infection among a Cohort of Primary Health Care Workers in Nigeria
2023, Texila International Journal of Public HealthGlobal prevalence of hepatitis B virus serological markers among healthcare workers: A systematic review and meta-analysis
2021, World Journal of HepatologyVaccination status and prevalence of hepatitis B virus infection among health-care workers in a tertiary health institution, Enugu State, Nigeria
2020, Proceedings of Singapore Healthcare