Hepatitis B immunization in healthcare workers

BACKGROUND Healthcare workers (HCWs) are at high risk for hepatitis B virus (HBV) infection. The aim of the study was to evaluate HBV immunization status and anti-HBs titer among HCWs. METHODS AntiHBs titer was prospectively examined in all vaccinated of the 464 HCWs enrolled. A comparison was done between two groups who had received vaccination within or beyond 5 years (Group A >5 years, Group B <5 years) and also between those who received a booster dose, Group I (<1 year) and Group II (>1 year). RESULTS 49.6% HCWs were vaccinated, 46.1% were unvaccinated, and 4.3% were partially vaccinated. Among HCWs, doctors had the highest vaccination rate of 92.5%, followed by medical students (62.4%), nursing staff (41.6%), technical staff (24.2%), administrative staff (12.1%), nursing students (8.5%), and grade IV/laundry staff (0%). Of the vaccinated HCWs, 30% had anti-HBs titer <10 mIU/mL, 10.8% between 10-100 mIU/mL, and 59.2% >100 mIU/mL. Mean anti-HBs titer between groups A and B was 334.8 and 649.2 mIU/mL, respectively (P<0.05); mean anti-HBs titer between groups I and II was 1742.7 and 629.2 mIU, respectively (P<0.002). CONCLUSION A significant proportion of HCWs is unvaccinated. A fair proportion of fully vaccinated HCWs can have low titers to protect them against HBV infection. Measuring anti-HBs titer, administering a booster dose, and offering general screening for HBs antigen should be made compulsory for HCWs.