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Seroconversion Rates in Healthcare Workers Using a Latex Agglutination Assay After Varicella Virus Vaccination

Published online by Cambridge University Press:  02 January 2015

David M. Weinstock
Affiliation:
Department of Medicine, New York Hospital-Cornell University Medical Center, New York City, New York
Maureen Rogers
Affiliation:
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York Hospital-Cornell University Medical Center, New York City, New York
Suzanne Lim
Affiliation:
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York Hospital-Cornell University Medical Center, New York City, New York
Janet Eagan
Affiliation:
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York Hospital-Cornell University Medical Center, New York City, New York
Kent A. Sepkowitz*
Affiliation:
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York Hospital-Cornell University Medical Center, New York City, New York Department of Medicine, New York Hospital-Cornell University Medical Center, New York City, New York
*
Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021

Abstract

Objectives:

To determine the seroconversion rate after varicella immunization of healthcare workers (HCWs) and the effect of seroconversion rate on current cost-based recommendations for universal vaccination.

Methods:

A voluntary vaccination program for HCWs was performed at a tertiary-care cancer center in New York City. A commercial latex agglutination assay was used to test postvaccination antibody response. Costs for vaccination and postvaccination serological testing were compared to potential costs of postexposure employee furloughs.

Results:

Of 263 seronegative HCWs, 96 (36.5%) began the vaccine program. Thirty-nine HCWs received only one dose of vaccine. Seven returned for follow-up antibody testing, of whom 4 were seropositive. Of the 57 HCWs who received two doses, 38 returned for follow-up serology. Thirty-one (81.6%) HCWs were seropositive for varicella-zoster virus antibodies, and seven HCWs (18.4%) remained seronegative. Total cost of vaccination for all 263 seronegative HCWs was estimated and compared to the cost of varicella-related furloughs at our institution.

Conclusions:

We found a considerably lower rate of vaccine-induced seroconversion at our hospital compared to that of the published literature. Despite this finding, universal varicella vaccination remained an extremely cost-effective alternative to the furloughing of exposed, seronegative HCWs. Projected hospital savings exceeded $53,000 in the first year after vaccination alone.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

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