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Abstract
All employees of St. Jude Children's Research Hospital who were at risk for occupational
exposure to hepatitis B virus were considered appropriate candidates for immunization
when the vaccine was licensed in November 1981. Because a high prevalence of hepatitis
B immunity was expected among the staff, preimmunization screening was undertaken
in the belief that it would be cost effective. Of 315 candidates screened for antibody
to the hepatitis B surface antigen (anti-HBs), 79 (25%) had detectable levels and
48 (15%) had titers of ≥10 ratio units (RU). The highest rates of anti-HBs positivity
were found among housekeepers (40%), nursing assistants (35%), physicians (31%), clinical
laboratory workers (29%), and ward clerks (27%); nurses had the lowest rate (16%).
An evaluation of potential risk factors implicated age >30 years as having greatest
importance. Serum samples were collected from 221 employees 3 months after their third
dose of vaccine and tested for anti-HBs; 218 (98.6%) were seropositive. Eighteen employees
who had detectable anti-HBs in the range of 2.1 to 9.9 RU before immunization responded
well to the vaccine; the titers rose from an average of 4 RU before vaccination to
an average of 313 RU 3 months after the third dose. The findings indicate that preimmunization
screening of all health care workers identified as candidates for vaccination may
not be necessary or economically feasible. If a screening program is undertaken, however,
anti-HBs testing of only those persons >30 years of age would increase the program's
cost effectiveness.
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References
- Viral hepatitis: An occupational hazard of medical personnel: Experience of the Yale-New Haven Hospital, 1952 to 1964.JAMA. 1966; 195: 362-364
- Australia antigen (a hepatitis-associated antigen) in leukemia.J Natl Cancer Inst. 1970; 44: 1241-1249
- A “new” antigen in leukemia sera.JAMA. 1965; 191: 541-546
- Outcome of hepatitis in children with acute leukemia.Am J Dis Child. 1980; 134: 584-587
- Hepatitis B in an oncology unit.N Engl J Med. 1974; 291: 1371-1375
- Prevalence of hepatitis B in a high-risk setting: A serological study of patients and staff in a pediatric oncology unit.Pediatrics. 1978; 61: 711-715
- Hepatitis surveillance report No. 48. Centers for Disease Control, AtlantaJune 1982 ed 2.
- Hepatitis B vaccine: Demonstration of efficacy in a controlled clinical trial in a high-risk population in the United States.N Engl J Med. 1980; 103: 833-841
- Occupational exposure to hepatitis B virus in hospital personnel: Infection or immunization?.Am J Epidemiol. 1981; 115: 26-39
- Epidemiology of hepatitis B in hospital personnel.Am J Epidemiol. 1975; 101: 59-64
- Use of ranks in one-criterion analysis of variance.JASA. 1952; 47: 583-621
- The newly licensed hepatitis B vaccine.JAMA. 1982; 247: 2012-2015
- Morbid Mortal Weekly Rep. 1982; 31: 317-328
- Hepatitis B vaccine-recommendations for hospital employees.The Association, ChicagoOctober 1982
- Passive-active immunization against hepatitis B: Immunogenicity studies in adult Americans.Lancet. 1981; 1: 575-577
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© 1984 Published by Elsevier Inc.