Abstract
Objective
To assess the concentration and kinetics of antibody response after hepatitis B vaccination among women healthcare workers. Design. Longitudinal retrospective seroepidemiological survey among women vaccinated against hepatitis B working in a university hospital and followed-up in an occupational health department. A structured form was used to collect socio-demographic characteristics, clinical data, age at vaccination, vaccination schedule, measurement of antibodies to hepatitis B surface antigen (anti-HBs antibody). Subjects were considered seronegative against hepatitis B when anti-HBs antibody concentration was less than 10 mIU/ml. Setting. A 1260-bed general hospital in Paris, France. Participants. All women healthcare workers visiting the occupational health department between January 1997 1st and December 2000 31st and who had a measurement of anti-HBs antibody.
Results
Irrespective of the age at the primary vaccination, 810 (92%) women were seropositive (anti-HBs antibody ≥10 mIU/ml). Only 22 women (4.5%) vaccinated before 26 years of age were seronegative, against 46 (13.2%) vaccinated after 25 years of age (p < 0.001). Seven years after vaccination, 78% of women were still seropositive. An inadequate vaccination schedule (adjusted hazard ratio (HR), 3.0; 95% confidence interval [CI], 1.6–5.5) and an age greater than 25 years at primary vaccination (HR, 2.6; 95% CI, 1.5–4.4) were associated with being seronegative against hepatitis B. Conclusions. Despite vaccination, some women healthcare workers were seronegative against hepatitis B virus. Vaccinating early in the career of a health-care worker using an adequate schedule seems key-elements to guarantee an anti-HBs measurement ≥10 mIU/ml.
Similar content being viewed by others
Abbreviations
- BMI:
-
body mass index
- CI:
-
confidence interval
- HBV:
-
hepatitis B virus
- HR:
-
hazard ratio
- IM:
-
intramuscular
- SD:
-
standard deviation
Reference
Pepe PE, Hollinger FB, Troisi CL, Heiberg D (1986) Viral hepatitis risk in urban emergency medical services personnel. Ann Emerg Med 15:454–57
Scheiermann N, Kuwert EK, Pieringer E, Dermietzel R (1978) High-risk groups for hepatitis B virus infection in a university hospital staff as determined by detection of HB antigens, antibodies, and Dane particles. Med Microbiol Immunol 166:241–47
Kane M (1995) Global programme for control of hepatitis B infection. Vaccine 13 Suppl 1:S47–S49
Abiteboul D, Forestier-Auter AF, Domart M, Laville MF, Touche S, Bouvet E, Leprince A, Conso F (2000) Les accidents avec exposition au sang. Concours Med 122:539–45
Mahoney FJ, Stewart K, Hu H, Coleman P, Alter MJ (1997) Progress toward the elimination of hepatitis B virus transmission among health care workers in the United States. Arch Intern Med 157:2601–605
Treadwell TL, Keeffe EB, Lake J, Read A, Friedman LS, Goldman IS, Howell CD, deMedina M, Schiff ER, Jensen DM, Koff RS (1993) Immunogenicity of two recombinant hepatitis B vaccines in older individuals. Am J Med 6:584–88
Yu AS, Cheung RC, Keeffe EB (2004) Hepatitis B vaccines. Clin Liver Dis 8:283–00
Roome AJ, Walsh SJ, Cartter ML, Hadler JL (1993) Hepatitis B vaccine responsiveness in Connecticut public safety personnel. JAMA 270:2931–934
Averhoff F, Mahoney F, Coleman P, Schatz G, Hurwitz E, Margolis H (1998) Immunogenicity of hepatitis B vaccines. Implications for persons at occupational risk of hepatitis B virus infection. Am J Prev Med 15:1–
Yu AS, Cheung RC, Keeffe EB (2006) Hepatitis B vaccine. Infect Dis Clin North Am 20:27–5
Alimonos K, Nafziger AN, Murray J, Bertino JS Jr (1998) Prediction of response to hepatits B vaccine in health care workers:whose titers of antibody to hepatitis B surface antigen should be determined after a three-dose series, and what are the implications in terms of cost-effectiveness? Clin Infect Dis 26:566–71
Bronowicki JP, Weber-Larivaille F, Gut JP, Doffoel M, Vetter D (1997) Comparison of immunogenicity of vaccination and serovaccination against hepatitis B virus in patients with alcoholic cirrhosis. Gastroenterol Clin Biol 21:848–53
Fleming SJ, Moran DM, Cooksley WG, Faoagali JL (1991) Poor response to a recombinant hepatitis B vaccine in dialysis patients. J Infect 22:251–57
Desombere I, Willems A, Leroux-Roels G (1998) Response to hepatitis B vaccine: Multiple HLA genes are involved. Tissue Antigens 51:593–04
Leroux-Roels G, Abraham B, Fourneau M, De Clercq N, Safary A (2000) A comparison of two commercial recombinant vaccines for hepatitis B in adolescents. Vaccine 19:937–42
Fonseca MO, Pang LW, de Paula Cavalheiro N, Barone AA, Heloisa Lopes M (2005) Randomized trial of recombinant hepatitis B vaccine in HIV-infected adult patients comparing a standard dose to a double dose. Vaccine 23:2902–908
Playford EG, Hogan PG, Bansal AS, Harrison K, Drummond D, Looke DF, Whitby M (2002) Intradermal recombinant hepatitis B vaccine for healthcare workers who fail to respond to intramuscular vaccine. Infect Control Hosp Epidemiol 23:87–0
Zuckerman JN, Zuckerman AJ, Symington I, Du W, Williams A, Dicson B, Young MD (2001) Hepacare Study Group. Evaluation of a new hepatitis B triple-antigen vaccine in inadequate responders to current vaccines. Hepatology 34:798–02
van der Sande MA, Waight P, Mendy M, Rayco-Solon P, Hutt P, Fulford T, Doherty C, McConkey SJ, Jeffries D, Hall AJ, Whittle HC (2006) Long-term protection against carriage of hepatitis B virus after infant vaccination. J Infect Dis 193:1528–535
Ballinger AB, Clark ML (1994) Severe acute hepatitis B infection after vaccination. Lancet 344:1292
Goffin E, Horsmans Y, Cornu C, Geubel A, Pirson Y (1995) Acute hepatitis B infection after vaccination. Lancet 345:263
West DJ, Calandra GB (1996) Vaccine induced immunologic memory for hepatitis B surface antigen:implications for policy on booster vaccination. Vaccine 14:1019–027
European consensus group on hepatitis B immunity (2000) Are booster immunisations needed for hepatitis B immunity? Lancet 355:561–65
Floreani A, Baldo V, Cristofoletti M, Renzulli G, Valeri A, Zanetti C, Trivello R (2004) Long-term persistence of anti-HBs after vaccination against HBV: An 18-year experience in health care workers. Vaccine 22:607–10
Boxall EH, Sira JA, El-Shuhkri N, Kelly DA (2004) Long term persistence of immunity to hepatitis B after vaccination during infancy in a country where endemicity is low. J Infect Dis 190:1264–269
Durlach R, Laugas S, Freuler CB, Rodriguez VE, Costa M (2003) Ten-year persistence of antibody to hepatitis B surface antigen in healthcare workers vaccinated against hepatitis B virus, and response to booster vaccination. Infect Control Hosp Epidemiol 24:773–76
Fisman DN, Agrawal D, Leder K (2002) The effect of age on immunologic response to recombinant hepatitis B vaccine: A meta-analysis. Clin Infect Dis 35:1368–375
Williams JL, Christensen CJ, Mc Mahon BJ, Bulkow LR, Cagle HH, Mayers JS, Zanis CL, Parkinson AJ, Margolis HS (2001) Evaluation of the response to a booster dose of hepatitis B vaccine in previously immunized healthcare workers. Vaccine 19:4081–085
Cassidy WM, Watson B, Ioli VA, Williams K, Bird S, West DJ (2001) A randomized trial of alternative two and three dose hepatitis B vaccination regimens in adolescents:antibody responses, safety, and immunologic memory. Pediatrics 107:626–31
Richardson D, Wing S, Steenland K, McKelvey W (2004) Time-related aspects of the healthy worker survivor effect. Ann Epidemiol 14:633–39
Goldwater PN (1997) Randomized, comparative trial of 20 μg versus 40 μg Engerix B vaccine in hepatitis B vaccine non-responders. Vaccine 15:353–56
Cardell K, Fryden A, Normann B (1999) Intradermal hepatitis B vaccination in health care workers. Response rate and experiences from vaccination in clinical practise. Scand J Infect Dis 31:197–00
Zuckerman JN, Zuckerman AJ (2002) Recombinant hepatitis B triple antigen vaccine:Hepacare. Expert Rev Vaccines 1:141–44
Jahnz-Rozyk K, Brydak LB, Targowski T, Machala M, Plusa T (2004) Effect of influenza vaccinations on immune response and serum eotaxin level in patients with allergic bronchial asthma. Mediators Inflamm 13:195–99
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Locquet, C., Marande, JL., Choudat, D. et al. Hepatitis B vaccination in women healthcare workers: A seroepidemiological survey. Eur J Epidemiol 22, 113–119 (2007). https://doi.org/10.1007/s10654-006-9094-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10654-006-9094-x