Hepatitis B vaccination is recommended for HCWs but has a non-response rate of 5%–32%. In Poland there is no standardised post-vaccination protocol to confirm immunity.
Objective To determine the fraction of those who were previously vaccinated but not checked for serologic evidence of hepatitis B immunity and to assess anti-HBs levels in that group by an anonymous cross-sectional sero-survey.
Methods surgical staff from 16 randomly selected hospitals in West Pomerania, Poland surveyed July 2010–January 2011.
Results of 488 participants (49 males, 439 females, Me age 42 years), in 361 (74.0%; 95% CI 69.9 to 77.7%) anti-HBs status was not determined after the basic course of HBV vaccination. Five per cent of those showed anti-HBs titre of 0.0 mIU/ml (6 of 9 given booster doses developed anti-HBs >10 mIU/ml) and 7.2% showed anti-HBs titre of 0.1–10 mIU/ml. The multivariate logistic regression model revealed that working in a teaching hospital was associated with a smaller odds of not being checked for serologic evidence of immunity after HBV vaccination (OR 0.22, 95% CI 0.14 to 0.35; p<0.0001).
Conclusions The majority of surgical staff do not confirm immunity after the basic course of HBV immunisation. Working in other than teaching hospital is related to increased odds of not confirming immunity. It is unclear whether 5% surveyed who showed no serologic evidence of hepatitis B immunity are non-responders, lost immunity, or retained anamnestic potential. Lack of booster vaccination response in 3/9 subjects suggests non-responders Therefore, strict post-vaccination testing to document immunity is crucial to detect non-responders among surgical staff constantly exposed to blood.
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