Skip to main content

Advertisement

SpringerLink
Log in

Hepatitis B vaccination in women healthcare workers: A seroepidemiological survey

  • Infectious Diseases
  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

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

  1. Pepe PE, Hollinger FB, Troisi CL, Heiberg D (1986) Viral hepatitis risk in urban emergency medical services personnel. Ann Emerg Med 15:454–57

    Article  CAS  PubMed  Google Scholar 

  2. 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

    Article  CAS  PubMed  Google Scholar 

  3. Kane M (1995) Global programme for control of hepatitis B infection. Vaccine 13 Suppl 1:S47–S49

    PubMed  Google Scholar 

  4. 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

    Google Scholar 

  5. 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

    Article  CAS  PubMed  Google Scholar 

  6. 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

    Article  Google Scholar 

  7. Yu AS, Cheung RC, Keeffe EB (2004) Hepatitis B vaccines. Clin Liver Dis 8:283–00

    Article  PubMed  Google Scholar 

  8. Roome AJ, Walsh SJ, Cartter ML, Hadler JL (1993) Hepatitis B vaccine responsiveness in Connecticut public safety personnel. JAMA 270:2931–934

    Article  CAS  PubMed  Google Scholar 

  9. 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–

    Article  CAS  PubMed  Google Scholar 

  10. Yu AS, Cheung RC, Keeffe EB (2006) Hepatitis B vaccine. Infect Dis Clin North Am 20:27–5

    Article  CAS  PubMed  Google Scholar 

  11. 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

    Article  CAS  PubMed  Google Scholar 

  12. 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

    CAS  PubMed  Google Scholar 

  13. 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

    Article  CAS  PubMed  Google Scholar 

  14. Desombere I, Willems A, Leroux-Roels G (1998) Response to hepatitis B vaccine: Multiple HLA genes are involved. Tissue Antigens 51:593–04

    Article  CAS  PubMed  Google Scholar 

  15. 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

    Article  CAS  PubMed  Google Scholar 

  16. 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

    Article  CAS  PubMed  Google Scholar 

  17. 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

    Article  PubMed  Google Scholar 

  18. 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

    Article  CAS  PubMed  Google Scholar 

  19. 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

    Article  PubMed  Google Scholar 

  20. Ballinger AB, Clark ML (1994) Severe acute hepatitis B infection after vaccination. Lancet 344:1292

    Article  CAS  PubMed  Google Scholar 

  21. Goffin E, Horsmans Y, Cornu C, Geubel A, Pirson Y (1995) Acute hepatitis B infection after vaccination. Lancet 345:263

    Article  CAS  PubMed  Google Scholar 

  22. West DJ, Calandra GB (1996) Vaccine induced immunologic memory for hepatitis B surface antigen:implications for policy on booster vaccination. Vaccine 14:1019–027

    Article  CAS  PubMed  Google Scholar 

  23. European consensus group on hepatitis B immunity (2000) Are booster immunisations needed for hepatitis B immunity? Lancet 355:561–65

    Article  Google Scholar 

  24. 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

    Article  CAS  PubMed  Google Scholar 

  25. 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

    Article  PubMed  Google Scholar 

  26. 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

    Article  PubMed  Google Scholar 

  27. 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

    Article  PubMed  Google Scholar 

  28. 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

    Article  CAS  PubMed  Google Scholar 

  29. 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

    Article  CAS  PubMed  Google Scholar 

  30. Richardson D, Wing S, Steenland K, McKelvey W (2004) Time-related aspects of the healthy worker survivor effect. Ann Epidemiol 14:633–39

    Article  PubMed  Google Scholar 

  31. 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

    Article  CAS  PubMed  Google Scholar 

  32. 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

    Article  CAS  PubMed  Google Scholar 

  33. Zuckerman JN, Zuckerman AJ (2002) Recombinant hepatitis B triple antigen vaccine:Hepacare. Expert Rev Vaccines 1:141–44

    Article  CAS  PubMed  Google Scholar 

  34. 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

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service de Médecine du Travail, Faculté de Médecine, Université Paris Descartes, 45, rue des Saints-Pères, 75006, Paris, France

    C. Locquet

  2. AP - HP, Groupe hospitalier Cochin - Saint Vincent de Paul, Service de Médecine du Travail, Paris, France

    J.-L. Marande

  3. AP - HP, Groupe hospitalier Cochin - Saint Vincent de Paul, Service de Pathologie Professionnelle, Faculté de Médecine, Université Paris Descartes, Paris, France

    D. Choudat

  4. AP - HP, Groupe hospitalier Cochin - Saint Vincent de Paul, Service de Santé Publique, Faculté de Médecine, Université Paris Descartes, Paris, France

    G. Vidal-Trecan

Authors
  1. C. Locquet
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J.-L. Marande
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Choudat
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Vidal-Trecan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Locquet.

Rights and permissions

Reprints 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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10654-006-9094-x

Keywords

Search

Navigation