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Hepatitis B Vaccination Coverage Levels Among Healthcare Workers in the United States, 2002-2003

Published online by Cambridge University Press:  02 January 2015

Edgar P. Simard ,
Jeremy T. Miller ,
Prethibha A. George ,
Annemarie Wasley ,
Miriam J. Alter ,
Beth P. Bell  and
Lyn Finelli
Edgar P. Simard*
Affiliation:
Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia University of Medicine and Dentistry of New Jersey, School of Public Health, Piscataway, New Jersey
Jeremy T. Miller
Affiliation:
General Dynamics Information Technology, Atlanta, Georgia
Prethibha A. George
Affiliation:
Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia University of Medicine and Dentistry of New Jersey, School of Public Health, Piscataway, New Jersey
Annemarie Wasley
Affiliation:
Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Miriam J. Alter
Affiliation:
Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia University of Texas Medical Branch at Galveston, Galveston, Texas
Beth P. Bell
Affiliation:
Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Lyn Finelli
Affiliation:
Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
*
317 George Street, Suite 210, New Brunswick, New Jersey 08901 (esimard@alum.emory.edu)
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Abstract

Background.

Hepatitis B virus (HBV) infection is a well recognized risk for healthcare workers (HCWs), and routine vaccination of HCWs has been recommended since 1982. By 1995, the level of vaccination coverage among HCWs was only 67%.

Objective.

To obtain an accurate estimate of hepatitis B vaccination coverage levels among HCWs and to describe the hospital characteristics and hepatitis B vaccination policies associated with various coverage levels.

Design.

Cross-sectional survey.

Methods.

A representative sample of 425 of 6,116 American Hospital Association member hospitals was selected to participate, using probability-proportional-to-size methods during 2002-2003. The data collected included information regarding each hospital's hepatitis B vaccination policies. Vaccination coverage levels were estimated from a systematic sample of 25 HCWs from each hospital whose medical records were reviewed for demographic and vaccination data. The main outcome measure was hepatitis B vaccination coverage levels.

Results.

Among at-risk HCWs, 75% had received 3 or more doses of the hepatitis B vaccine, corresponding to an estimated 2.5 million vaccinated hospital-based HCWs. The coverage level was 81% among staff physicians and nurses. Compared with nurses, coverage was significantly lower among phlebotomists (71.1%) and nurses' aides and/or other patient care staff (70.9%; P < .05). Hepatitis B vaccination coverage was highest among white HCWs (79.5%) and lowest among black HCWs (67.6%; P < .05). Compared with HCWs who worked in hospitals that required vaccination only of HCWs with identified risk for exposure to blood or other potentially infectious material, hepatitis B vaccination coverage was significantly lower among HCWs who worked in hospitals that required vaccination of HCWs without identified risk for exposure to blood or other potentially infectious material (76.6% vs 62.4%; P < .05).

Conclusions.

In the United States, an estimated 75% of HCWs have been vaccinated against hepatitis B. Important differences in coverage levels exist among various demographic groups. Hospitals need to identify methods to improve hepatitis B vaccination coverage levels and should consider developing targeted vaccination programs directed at unvaccinated, at-risk HCWs who have frequent or potential exposure to blood or other potentially infectious material.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 7 , July 2007 , pp. 783 - 790
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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References

1.Gibas, A, Blewett, DR, Schoenfeld, DA, Dienstag, JL. Prevalence and incidence of viral hepatitis in health workers in the prehepatitis B vaccination era. Am J Epidemiol 1992;136:603–610.CrossRefGoogle ScholarPubMed
2.Dienstag, JL, Ryan, DM. Occupational exposure to hepatitis B virus in hospital personnel: infection or immunization? Am J Epidemiol 1982;115:26–39.Google Scholar
3.Hadler, SC, Doto, IL, Maynard, IE, et al.Occupational risk of hepatitis B infection in hospital workers. Infect Control 1985;6:24–31.CrossRefGoogle ScholarPubMed
4.West, DJ. The risk of hepatitis B infection among health professionals in the United States: a review. Am J Med Sci 1984;287:26–33.CrossRefGoogle ScholarPubMed
5.Shapiro, CN. Occupational risk of infection with hepatitis B and hepatitis C virus. Surg Clin North Am 1995;75:1047–1056.CrossRefGoogle ScholarPubMed
6.Beltrami, EM, Williams, IT, Shapiro, CN, Chamberland, ME. Risk and management of blood-borne infections in health care workers. Clin Microbiol Rev 2000;13:385–407.CrossRefGoogle ScholarPubMed
7.Panlilio, AL, Orelien, JG, Srivastava, PU, et al.Estimate of the annual number of percutaneous injuries among hospital-based healthcare workers in the United States, 1997-1998. Infect Control Hosp Epidemiol 2004;25:556–562.CrossRefGoogle ScholarPubMed
8.Centers for Disease Control and Prevention. Hepatitis Surveillance Report Number 60. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2005.Google Scholar
9.Centers for Disease Control. Recommendation of the Immunization Practices Advisory Committee (ACIP). Inactivated hepatitis B virus vaccine. MMWR Morb Mortal Wkly Rep 1982;31:317–318.Google Scholar
10.US Department of Labor, Occupational Safety and Health Administration. Bloodborne Pathogens. 29 CFR §1910.1030 (1991).Google Scholar
11.Agerton, TB, Mahoney, FJ, Polish, LB, Shapiro, CN. Impact of the bloodborne pathogens standard on vaccination of healthcare workers with hepatitis B vaccine. Infect Control Hosp Epidemiol 1995;16:287–291.Google Scholar
12.Mahoney, FJ, Stewart, K, Hu, H, Coleman, P, Alter, MJ. Progress toward the elimination of hepatitis B virus transmission among health care workers in the United States. Arch Intern Med 1997;157:2601–2605.CrossRefGoogle ScholarPubMed
13.US Department of Health and Human Services. Healthy People 2010 with Understanding and Improving Health and Objectives for Improving Health. 2 vols. 2nd ed. Washington, DC: US Government Printing Office; 2002.Google Scholar
14.American Hospital Association Annual Survey Database (http://www.healthforum.com/healthforum/html/data_statistics/data_statistics.html). Washington, DC: American Hospital Association, Health Forum. Accessed luly 1, 2005.Google Scholar
15.Centers for Disease Control and Prevention. Sampling Procedure for Conducting Immunization Assessment Validation Surveys for School and Day Care Centers. Atlanta, GA: US Department of Health and Human Services: Centers for Disease Control and Prevention; 1990.Google Scholar
16.Serfling, RE, Sherman, IL. Attribute Sampling Methods for Local Health Departments, With Special Reference to Immunization Surveys. US Department of Health, Education, and Welfare: Public Health Service; 1965.Google Scholar
17.Lohr, SL. Sampling: Design and Analysis. 1st ed. New York, NY: Duxbury Press; 1999.Google Scholar
18.SAS Institute Inc. SAS Online Doc 9.1.3. Carey, NC: SAS Institute Inc; 2005.Google Scholar
19.Research Triangle Institute. SUDAAN Language Manual, Release 9.0. Research Triangle Park, NC: Research Triangle Institute; 2004.Google Scholar
20.Hosmer, DW, Lemeshow, S. Applied Logistic Regression. 2nd ed. New York, NY: John Wiley & Sons, Inc; 2000.Google Scholar
21.Spence, MR, Dash, GP. Hepatitis B: perceptions, knowledge and vaccine acceptance among registered nurses in high-risk occupations in a university hospital. Infect Control Hosp Epidemiol 1990;11:129–133.CrossRefGoogle ScholarPubMed
22.Larson, E. Racial and ethnic disparities in immunizations: recommendations for clinicians. Farn Med 2003;35:655–660.Google Scholar
23.Luman, ET, Barker, LE, Shaw, KM, McCauley, MM, Buehler, JW, Pickering, LK. Timeliness of childhood vaccinations in the United States: days undervaccinated and number of vaccines delayed. JAMA 2005;293:1204–1211.CrossRefGoogle ScholarPubMed
24.Doebbeling, BN, Ferguson, KJ, Kohout, FJ. Predictors of hepatitis B vaccine acceptance in health care workers. Med Care 1996;34:58–72.CrossRefGoogle ScholarPubMed
25.King, WD, Woolhandler, SJ, Brown, AF, et al.Brief report: influenza vaccination and health care workers in the United States. J Gen Intern Med 2006;21:181–184.Google Scholar
26.Shapiro, CN, Tokars, JI, Chamberland, ME. Use of the hepatitis-B vaccine and infection with hepatitis B and C among orthopaedic surgeons. The American Academy of Orthopaedic Surgeons Serosurvey Study Committee. J Bone Joint Surg 1996;78:1791–1800.Google Scholar
27.Centers for Disease Control and Prevention (CDC). Transmission of hepatitis B and C viruses in outpatient settings—New York, Oklahoma, and Nebraska, 2000-2002. MMWR Morb Mortal Wkly Rep 2003;52:901–906.Google Scholar
28.Centers for Disease Control and Prevention (CDC). Transmission of hepatitis B virus among persons undergoing blood glucose monitoring in long-term-care facilities—Mississippi, North Carolina, and Los Angeles County, California, 2003-2004. MMWR Morb Mortal Wkly Rep 2005;54:220–223.Google Scholar
29.Williams, IT, Perz, JF, Bell, BP. Viral hepatitis transmission in ambulatory health care settings. Clin Infect Dis 2004;38:1592–1598.Google Scholar