Hepatitis B vaccination for staff in institutions for the mentally handicapped

Abstract

A request was made by the Director of Social Services of a London Borough about protection for staff in institutions for the severely mentally handicapped (both residential and non-residential) against Hepatitis B. As available evidence indicated that there is a risk, though very low, to these staff of contracting Hepatitis B from their clients, the author decided to screen the staff for their immune status before advising vaccination against Hepatitis B. Ninety-seven staff working in institutions for the mentally handicapped were screened for the presence of Hepatitis B markers (HBs Ag and anti-HBs Ag) to determine their immune status. It was found that 6.2% were immune to HBV infection as shown by the presence of adequate titres of anti-HBs Ag in their blood. None of the staff were found to have HBs Ag in their blood. All susceptible persons were advised to seek vaccination against HBV infection if they so wished, because of the increased risk of contracting the infection from their clients. The cost of screening 97 staff was more than twice the cost that would have been incurred if the 6 immune persons had been vaccinated without prior testing for their immune status. Hence it seems economical to offer vaccination against HBV infection to staff working in institutions for the mentally handicapped without prior screening for their immune status.