Abstract
Health-care students can be exposed to biological risks during university training. The persistence of long-term immunogenicity against hepatitis B virus (HBV) was analyzed in a cohort of nursing students two decades after primary vaccination. A total of 520 students were enrolled at the University of Palermo and were evaluated for levels of anti-HBsAg antibodies. The students were examined during the first year of their Degree Course and were checked two years later. All students with anti-HBsAg <10 mIU/mL during their first or third year were boosted within one month. The proportion of students that were vaccinated during adolescence showing anti-HBsAg ≥10 mIU/mL was higher than that observed in students who were vaccinated during infancy (69% versus 31.7%; p-value < 0.001). Receiving HBV vaccination at adolescence was significantly associated with a fourfold increased possibility of having anti-HBsAg titers ≥10 mIU/mL (adj-OR = 4.21, 95% CI: 2.43–7.30). Among the students who were checked at the third year and boosted after the first year (n = 279), those who were vaccinated during infancy showed a higher percentage of antibody titers <10 mIU/mL (20.3% versus 8.7% among vaccinated during adolescence; p < 0.01). This study confirms that HBV vaccination at adolescence might determine a higher long-term persistence of anti-HBsAg titers ≥10 mIU/mL and that anti-HBV booster could increase levels of anti-HBsAg over a relatively short period, especially in subjects who were vaccinated during infancy.
Highlights
IntroductionThe World Health Organization (WHO) estimates that about 59 million health care workers (HCWs) are exposed to multiple occupational hazards every day, the most common being the risk of exposure to infected patients and/or infectious materials, including body fluids, contaminated medical supplies and equipment, environmental surfaces, or air [1].In particular, hepatitis B virus (HBV) represents the most transmissible blood-borne virus following percutaneous exposure among healthcare workers [2].Vaccines 2020, 8, 1; doi:10.3390/vaccines8010001 www.mdpi.com/journal/vaccinesIn Italy, according to the national law, healthcare students are considered workers and, if they are exposed to physical, chemical, biological, or psychological risks, they should be examined by an occupational health physician to evaluate the risks related to their practical activities [3].Standard precautions, the adoption of enhanced percutaneous injury precautions, and HBV vaccination of HCWs have been demonstrated to consistently reduce the risk of occupational infections and prevent nosocomial transmission of the virus [4].About 95% of the population who are vaccinated against HBV will develop an effective immune response, which can be confirmed by the evaluation of antiHBsAg antibodies (protective level ≥10 mIU/mL) [5].Some studies suggest that the acquired immunity persists for at least 10 years after vaccination with antibody levels ≥10 mIU/mL, probably not longer if vaccination was performed during the neonatal age [6,7]
Among the students who were checked at the third year and boosted after the first year (n = 279), those who were vaccinated during infancy showed a higher percentage of antibody titers
This study confirms that hepatitis B virus (HBV) vaccination at adolescence might determine a higher long-term persistence of anti-HBsAg titers ≥10 mIU/mL and that anti-HBV booster could increase levels of anti-HBsAg over a relatively short period, especially in subjects who were vaccinated during infancy
Summary
The World Health Organization (WHO) estimates that about 59 million health care workers (HCWs) are exposed to multiple occupational hazards every day, the most common being the risk of exposure to infected patients and/or infectious materials, including body fluids, contaminated medical supplies and equipment, environmental surfaces, or air [1].In particular, hepatitis B virus (HBV) represents the most transmissible blood-borne virus following percutaneous exposure among healthcare workers [2].Vaccines 2020, 8, 1; doi:10.3390/vaccines8010001 www.mdpi.com/journal/vaccinesIn Italy, according to the national law, healthcare students are considered workers and, if they are exposed to physical, chemical, biological, or psychological risks, they should be examined by an occupational health physician to evaluate the risks related to their practical activities [3].Standard precautions, the adoption of enhanced percutaneous injury precautions, and HBV vaccination of HCWs have been demonstrated to consistently reduce the risk of occupational infections and prevent nosocomial transmission of the virus [4].About 95% of the population who are vaccinated against HBV will develop an effective immune response, which can be confirmed by the evaluation of antiHBsAg antibodies (protective level ≥10 mIU/mL) [5].Some studies suggest that the acquired immunity persists for at least 10 years after vaccination with antibody levels ≥10 mIU/mL, probably not longer if vaccination was performed during the neonatal age [6,7]. The World Health Organization (WHO) estimates that about 59 million health care workers (HCWs) are exposed to multiple occupational hazards every day, the most common being the risk of exposure to infected patients and/or infectious materials, including body fluids, contaminated medical supplies and equipment, environmental surfaces, or air [1]. Hepatitis B virus (HBV) represents the most transmissible blood-borne virus following percutaneous exposure among healthcare workers [2]. The adoption of enhanced percutaneous injury precautions, and HBV vaccination of HCWs have been demonstrated to consistently reduce the risk of occupational infections and prevent nosocomial transmission of the virus [4]. About 95% of the population who are vaccinated against HBV will develop an effective immune response, which can be confirmed by the evaluation of antiHBsAg antibodies (protective level ≥10 mIU/mL) [5].
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