Immunization and health workers: overview

Abstract

The need for effective defences against attack by pathogens is a key requirement for all workers particularly in the health care setting where there is the everpresent risk of nosocomial infection. In a review conducted between 1983 and 1996, .15 different types of respiratory infections were documented as having been acquired by health care workers in the occupational setting [1], and in the recent severe acute respiratory syndrome (SARS) outbreak up to 10% of infections were occupationally acquired. Protection against such infections is based on appropriate isolation of the patient and effective precautions for the worker (including hand hygiene); for a smaller number of infections, specific vaccinations provide an additional protective measure. The first article in this series of three will look at the use of vaccination in the occupational health setting. Paper 1 will review both the innate and adaptive responses to invading pathogenic microorganisms and the mechanisms of recognition and elimination of invading pathogens as these are also the basis for the immunization process. Paper 2 will consider active and passive immunity and the types of vaccines used in the occupational health setting; it will then explore adaptive responses with particular reference to immunization in the occupational health setting. Paper 3 provides an update on current practice in relation to immunization of health care workers. Updates on vaccine safety assurance are discussed in particular focusing on influenza, chickenpox and hepatitis B vaccines.