Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-26T07:23:30.815Z Has data issue: false hasContentIssue false
  • English
  • Français

A Hepatitis B Vaccination Program in a Community Teaching Hospital

Published online by Cambridge University Press:  02 January 2015

Myron J. Tong ,
Ann M. Howard ,
Gary C. Schatz ,
Mark A. Kane ,
Deborah A. Roskamp ,
Ruth L. Co  and
Cissy Boone
Myron J. Tong*
Affiliation:
Liver Center, Huntington Memorial Hospital, Pasadena, California, and the Centers for Disease Control, Atlanta, Georgia
Ann M. Howard
Affiliation:
Liver Center, Huntington Memorial Hospital, Pasadena, California, and the Centers for Disease Control, Atlanta, Georgia
Gary C. Schatz
Affiliation:
Liver Center, Huntington Memorial Hospital, Pasadena, California, and the Centers for Disease Control, Atlanta, Georgia
Mark A. Kane
Affiliation:
Liver Center, Huntington Memorial Hospital, Pasadena, California, and the Centers for Disease Control, Atlanta, Georgia
Deborah A. Roskamp
Affiliation:
Liver Center, Huntington Memorial Hospital, Pasadena, California, and the Centers for Disease Control, Atlanta, Georgia
Ruth L. Co
Affiliation:
Liver Center, Huntington Memorial Hospital, Pasadena, California, and the Centers for Disease Control, Atlanta, Georgia
Cissy Boone
Affiliation:
Liver Center, Huntington Memorial Hospital, Pasadena, California, and the Centers for Disease Control, Atlanta, Georgia
*
Liver Center, Huntington Memorial Hospital, 100 Congress Street, Pasadena, CA 91105
Get access Rights & Permissions [Opens in a new window]

Abstract

Prior to offering the hepatitis B (HB) vaccine, a prescreen for hepatitis B virus (HBV) antibodies was conducted in a 565 bed hospital in Pasadena, California. Antibodies to the hepatitis B virus were detected in 14.5% of 1,745 employees tested. There was a significantly higher prevalence in those with a previous history of hepatitis, blood transfusions, exposure to nee-dlesticks, number of years in the same occupation, and in the same hospital work area. Employees of Asian extraction (33.3%) and blacks (23.1%) had a higher prevalence of antibodies to the hepatitis B virus than Hispanics (13.7%) and whites (10.2%). Anti-HBs was detected in 92.6% of 865 employees who received three doses of the hepatitis B vaccine. Only 28.6% of nonresponders receiving a fourth dose of hepatitis B vaccine produced anti-HBs. The nonresponders to the HB vaccine were older (average age 64.9 years) when compared to the responders (average age 37.5 years), and more males failed to produce anti-HBs after vaccination than females. Hepatitis B vaccination of the majority of individuals with either “low level” anti-HBs alone or anti-HBc alone did not elicit an anamnestic response after one dose of vaccine, implying that these “low level” antibodies are nonspecific and do not represent antiviral antibodies. Adverse reactions to the hepatitis B vaccine were minor and included a flulike syndrome, sore arm, and rash and swelling at the injection site. The reasons for nonparticipation were obtained from 179 individuals, and the main issue was concern about safety of the hepatitis B vaccine.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 8 , Issue 3 , March 1987 , pp. 102 - 107
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1987

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Tong, MJ: Chronic hepatitis in hepalology, in Zakim, & Boyer, (eds): Hepalology. Philadephia, W.B. Saunders, 1982, pp 972–990.Google Scholar
2.Dienstag, JL, Werner, BG, Polk, BF, el al: Hepatitis B vaccine in health care personnel: Safety, immuncgenicity, and indicators of efficacy. Ann Intern Med 1984; 101:34–40.Google Scholar
3.Hadler, SC, Murphy, BL, Sellable, CA, et al: Epidemiological analysis of the significance of low-positive test results for antibody to hepatitis B surface and core antigens. J Clin Microbiol 1984; 19(4):521–525.Google Scholar
4.Smith, JL: Comparative risk of hepatitis B among physicians and demists. J Infect Dis 1986; 133(6):705–706.Google Scholar
5.Denes, AE, Smith, JL, Maynard, JE, el al: Hepatitis B infection in physicians: Results of a nationwide seroepidemiologic survey. JAMA 1978; 239:210–212.Google Scholar
6.Grady, GF: Hepatitis B immunity in hospital staff targeted for vaccination. JAMA 1982; 248:2266–2269.Google Scholar
7.Hadler, SC, Doto, IL, Maynard, JE, el al: Occupational risk of hepatitis B infection in hospital workers. Infect Control 1985; 6(1):24–31.Google Scholar
8.Lewis, TL, Alter, HJ, Chalmers, TC, et al: A comparison of the frequency of hepatitis B antigen and antibody in hospital and nonhospital personnel. N Engl J Med 1973; 289:648–651.Google Scholar
9.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
10.Tong, MJ, Yu, M, Co, R, el al: Hepatitis B virus markers in the foreign-born Chinese population of Los Angeles, California. J Infect Dis 1984; 149(3):475.Google Scholar
11.Wong, VCW, Reesink, HW, Ip, HMH, et al: Prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAgby administration of hepatitis B vaccine and hepatitis B immunoglobulin. Lancet 1984; 4:922–926.Google Scholar
12.Tong, MJ, Nair, P, Thursby, M, et al: Studies on perinatal transmission of hepatitis B virus in Los Angeles. Viral Hepatitis and Liver Disease 1984; 50:533–536.Google Scholar
13.Palmer, DL, Barash, M, King, R, et al: Hepatitis among hospital employees. West J Med 1983; 138:519–523.Google Scholar
14.Stevens, CE, Alter, HJ, Taylor, PE, et al: Hepatitis B vaccine in patients receiving hemodialysis. N Engl J Med 1984; 311:496–501.Google Scholar
15.Francis, DP, Hadler, SC, Thompson, SE, et al: The prevention of hepatitis B with vaccine: Report of the Centers for Disease Control multi-center efficacy trial among homosexual men. Ann Intern Med 1982; 97:362–366.Google Scholar
16.Szmuness, W, Stevens, CE, Harley, EJ, et al: Hepatitis B vaccine. Demonstration of efficacy in a controlled clinical trial in a high-risk population in the United Slates. N Engl J Med 1980; 303:833–841.Google Scholar
17.Nowicki, MJ, Tong, MJ, Bohman, RE: Alterations in the immune response of nonresponders to the hepatitis B vaccine. J Infect Dis 1985; 152(6): 1245–1248.Google Scholar
18.Hepatitis B vaccine: Evidence confirming lack of AIDS transmission. MMWR 1984; 33(49):685–687.Google Scholar
19.Francis, DP, Feorino, PM. McDougal, S: The safely of the hepatitis B vaccine: Inactivation of the AIDS virus during routine vaccine manufacture. JAMA 1986; 256:869–872.Google Scholar
20.Jacobson, IM, Dienstag, JL, Zachoval, R, el al: Lack of effect of hepatitis B vaccine on T-cell phenotypes. N Engl J Med 1982; 311:1030–1032.Google Scholar
21.Klimek, JJ, Brettman, L, Neuhaus, E, et al: A multi-hospital hepatitis B vaccine program: Prevalence of antibody and acceptance of vaccination among high-risk hospital employees. Infect Control 1985; 6(1):32–34.Google Scholar