Abstract
Active immunization is the most important measure for controlling hepatitis B (HB) virus infection. The outcome of HB vaccination has been investigated in only a very small number of cohort studies, some of which found a number of cases of HBV infection. Using a design different from that of earlier studies, we have investigated the occurrence of HBV infection and clinical HB disease in individuals who had a complete HB vaccination series. Reported cases of HB/HBV infections among 1235 German health care workers (HCW) were analyzed with special regard to the question of whether or not HB vaccination had taken place in the past. 23 persons had undergone a complete vaccination series with complete documentation: 18 were non-responders (post-vaccination anti-HBs < 10 IU/l), one was a low-responder (anti-HBs < 100 IU/l), and four were responders (100 IU/l).While all responders seroconverted without clinical sign of hepatitis, ten non-/low-responders contracted chronic HB/HBV infection and seven contracted self-limiting HB. Vaccination should be only regarded as "successful", if the post-vaccination anti-HBs concentration is at least 100 IU/l.
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