Article| Volume 12, ISSUE 5, P261-265, October 1984

Download started.


Natural and induced immunity to hepatitis B virus among the staff of a pediatric oncology center

      This paper is only available as a PDF. To read, Please Download here.


      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.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Infection Control
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Byrne E.B.
        Viral hepatitis: An occupational hazard of medical personnel: Experience of the Yale-New Haven Hospital, 1952 to 1964.
        JAMA. 1966; 195: 362-364
        • Sutnick A.I.
        • London W.T.
        • Blumberg B.S.
        • Yankee R.A.
        • Gerstley B.J.
        • Millman I.
        Australia antigen (a hepatitis-associated antigen) in leukemia.
        J Natl Cancer Inst. 1970; 44: 1241-1249
        • Blumberg B.S.
        • Alter H.J.
        • Visnick S.
        A “new” antigen in leukemia sera.
        JAMA. 1965; 191: 541-546
        • Malone W.
        • Novak R.
        Outcome of hepatitis in children with acute leukemia.
        Am J Dis Child. 1980; 134: 584-587
        • Wands J.R.
        • Walker J.A.
        • Davis T.T.
        • Watterman L.A.
        • Owens A.H.
        • Carpenter C.I.
        Hepatitis B in an oncology unit.
        N Engl J Med. 1974; 291: 1371-1375
        • Tabor E.
        • Gerety R.J.
        • Mott M.
        • Wilbur J.
        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
        • Centers for Disease Control
        ed 2. Hepatitis surveillance report No. 48. Centers for Disease Control, AtlantaJune 1982
        • Szmuness W.
        • Stevens C.E.
        • Harley E.J.
        • et al.
        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
        • Dienstag J.L.
        • Ryan D.M.
        Occupational exposure to hepatitis B virus in hospital personnel: Infection or immunization?.
        Am J Epidemiol. 1981; 115: 26-39
        • Pattison C.P.
        • Maynard J.E.
        • Berquist K.R.
        • Webster H.M.
        Epidemiology of hepatitis B in hospital personnel.
        Am J Epidemiol. 1975; 101: 59-64
        • Kruskal W.H.
        • Wallis W.A.
        Use of ranks in one-criterion analysis of variance.
        JASA. 1952; 47: 583-621
        • Krugman S.
        The newly licensed hepatitis B vaccine.
        JAMA. 1982; 247: 2012-2015
        • Centers for Disease Control
        Morbid Mortal Weekly Rep. 1982; 31: 317-328
        • American Hospital Association
        Hepatitis B vaccine-recommendations for hospital employees.
        The Association, ChicagoOctober 1982
        • Szmuness W.
        • Stevens C.E.
        • Oleszko W.R.
        • Goodman A.
        Passive-active immunization against hepatitis B: Immunogenicity studies in adult Americans.
        Lancet. 1981; 1: 575-577