Dose Of Hepatitis B Vaccine Research Articles

Population and sub-national (district) level diversity in missed and dropout of different doses of hepatitis-B vaccine among Indian children aged 12-59 months.

Initiating with a birth dose and a full immunization against hepatitis-B is crucial during early childhood in a country like India where maternal screening of hepatitis-B surface antigen is almost negligible and there is a considerable risk of vertical transmission among children. It is also evident that coverage of hepatitis-B is lowest among all other vaccine doses included in the universal immunization program. In addition, the major challenge is posed by the missed and drop-out of different doses of hepatitis-B among Indian children. In this context, this study examined the population and sub-national level diversity in missed and dropout of different doses of hepatitis-B vaccine in India. We analysed a large dataset of 196,654 children aged 12-59 months from a nationally representative cross-sectional survey, the National Family Health Survey (NFHS), 2015-16. Bivariate cross tabulation was used to estimate the prevalence and the dropout rates. Multivariable-adjusted logistic regression was applied to assess the likelihood of the study events. Within a Bayesian framework, a district-level spatial analysis was conducted employing the Besag-York-Mollie (BYM) Model and the Leroux Model. During 2016, 38% of the children missed the birth dose nationally and 45% of the children did not complete full immunization of hepatitis-B. Findings suggest, presence of socio-economic and demographic gradients in missed and drop-out of different doses of hepatitis-B at national level. The sub-national level spatial analysis identifies more than 280 (out of 640) districts with substantially higher risk (Posterior Median Risk>1) in terms of missed and drop-out of different doses. Most of these districts are scattered across the North-Eastern and Northern part of India. The findings hint the existence of a population and sub-national level diversity in India's missed out and dropout of hepatitis-B doses. Identifying high risk population sub-groups and the districts with children at higher risk of missing the birth and consecutive doses informs the existing knowledge base and helps in formulating community-oriented policies and programs.

The dynamics and association of B and T cell receptor repertoires upon antibody response to hepatitis B vaccination in healthy adults

ABSTRACT The Hepatitis B (HB) vaccine is efficacious in preventing hepatitis B virus infection. However, the association between antibody response to the HB vaccine and dynamic immune repertoire changes in different cell subsets remains unclear. Nine healthy participants were administered three doses of HB vaccine following the 0, 1, 6 month schedule. Peripheral CD4+ T, memory B (MB), naïve B (NB), and plasma cells (PCs) were sorted before vaccination and 7 days following each dose. The complementary determining region 3 of T-cell receptor β (TCRβ) chain and B-cell receptor (BCR) heavy chain (IgG, IgM, IgA) repertoires were analyzed by high-throughput sequencing. All nine participants elicited protective antibody titers to the vaccine at the end of immunization. Compared with the baseline, MB cells showed a significant increase in IgG usage and decreased IgM usage and repertoire diversity at the end of vaccination. TCRβ diversity changes were highly correlated with those of the BCR in MB cells in participants with a faster and robust antibody responses. The percentage of shared clonotypes between NB and MB cells, and MB cells and PCs were much higher than that between NB cells and PCs. The more clonotypes sharing the faster and stronger antibody responses were observed after HB vaccination. These results suggest the integral involvement of MB cells in vaccine immunization. Interaction between CD4+ T and MB cells and B cell differentiation may improve antibody response to HB vaccine.

Immune persistence induced by three doses of 60 μg hepatitis B vaccine in non-responders following standard primary vaccination in Chinese adults

ABSTRACT This study consisted of two rounds of cross-sectional observations designed to evaluate the persistence of immune protection induced high antigen content hepatitis B (HB) vaccine at 60 μg/1.0 ml formulations administered at a three-dose schedule (Days 0, 28, and 56) in non-responders to routine HB vaccination. In the original phase 3 study, we enrolled 1091 healthy participants (16–60 years old) seronegative for antibody against HB surface antigen (anti-HBs) after primary vaccination. Participants were randomized (2:2:1) to receive three booster doses of HB vaccine containing 60 μg, 30 μg, or 10 μg of antigen per dose 28 days apart. In the group receiving the 60 μg HB vaccine, 428 participants’ serum samples were available at pre-vaccination and 28 days after each vaccine dose and were included in immunogenicity analysis. With two written informed consents, we collected blood samples from 276 (67.2%) participants in 2014 and 239 (58.2%) in 2019, who had completed the full course of revaccination and reached the seropositive (anti-HBs≥10 mIU/ml) standard in the 60 μg vaccine group of the original phase 3 study. The HBV seropositive rate was found to decrease from 96.0% in 28 days after receiving the third dose of 60 μg HB vaccine, to 48.2% in 2014, and to 40.6% in 2019, with anti-HBs GMC of seropositive individuals was 584.0 mIU/ml, 142.4 mIU/ml, and 169.1 mIU/ml, respectively. Analysis of 181 vaccinees who had serologic test results available both in 2014 and in 2019, and results revealed a dynamic trend in anti-HBs titer similar to that for the whole immune persistence cohort. Of paramount importance, the serologic test results found that 24.9% (45/181) participants had higher anti-HBs concentrations in 2019 than in 2014, this could be interpreted as natural boosters, secondary to HBV exposure without infection because protected. In conclusion, protective antibody persists about 11 years after immunization of Chinese non-responders with 3 doses of 60 μg HB vaccine. Booster doses of vaccine do not seem necessary to ensure long-term protection.

Cross-Protection of Hepatitis B Vaccination among Different Genotypes.

Hepatitis B (HB) vaccination is the most effective method for preventing HB virus (HBV) infection. Universal HB vaccination containing recombinant HB surface antigens (HBsAg) is recommended. Our data revealed that human monoclonal HB surface antibody (anti-HBs) from individuals inoculated with genotype C-based HB vaccine induced cross-protection against HBV genotype A infection. An in vitro infection model demonstrated anti-HBs-positive sera from individuals inoculated with genotype A- or C-based HB vaccine harbored polyclonal anti-HBs that could bind to non-vaccinated genotype HBV. However, because there were low titers of anti-HBs specific for HBsAg of non-vaccinated genotype, high anti-HBs titers would be required to prevent non-vaccinated genotype HBV infection. Clinically, the 2015 Centers for Disease Control and Prevention guidelines state that periodic monitoring of anti-HBs levels after routine HB vaccination is not needed and that booster doses of HB vaccine are not recommended. However, the American Red Cross suggests that HB-vaccine-induced immune memory might be limited; although HB vaccination can prevent clinical liver injury (hepatitis), subclinical HBV infections of non-vaccinated genotypes resulting in detectable HB core antibody could not be completely prevented. Therefore, monitoring anti-HBs levels after routine vaccination might be necessary for certain subjects in high-risk groups.

STUDY OF IMMUNE RESPONSE AFTER HEPATITIS B VACCINATION IN DOCTORS

Background: Aim of our study was to evaluate the immune response after hepatitis B vaccination and to determine the duration of protective levels of HBsAb titre in doctors. From our study we concluded that hepatitis-B vaccine gives protection for more than 10 years after primary vaccination and booster dose of Hepatitis-B vaccine is not required in immunocompetent persons after primary vaccination.
 Method: In this study total 100 doctors of our institution were included who were vaccinated against hepatitis B. Data were obtained regarding age, sex, weight, height, BMI and duration of vaccination period. Doctors with no prior vaccination or incomplete vaccination or those who took booster vaccination were excluded from this study.
 Results: The mean titre was observed to be higher in 30 to 34 years of age group (584.42±4.03.21) as compared to age group of less than 25 and greater than 40 years. Moreover, males were observed to have higher mean titre as compared to females. (411.64± 417.27 vs 333.66± 431.49) but not statistically significant. Similar with age and sex, duration of vaccination status was also not statistically significant. When we compared the duration of vaccination status with age group , mean titre was more in ≥30 years of age group as compared to <30 years (younger age groups) but statistically significant relation was observed only with the 1 month to <5 years of duration.
 Conclusion: From our study we concluded that hepatitis-B vaccinegives protection for more than 10 years after primary vaccination and booster dose of Hepatitis-B vaccine is not required inimmuno-competent persons after primary vaccination.
 Keywords: HbsAg titre , HepatitsB vaccine , seroprotection rate.

Evaluation of the efficacy of accelerated hepatitis B vaccine among students of Assiut Nursing School and College

Introduction Hepatitis B (HB) vaccine prevents infection with hepatitis B virus, thus reducing the incidence of chronic hepatitis, liver cirrhosis, hepatocellular carcinoma, and transmission of infection to susceptible individuals. Vaccine-induced immune response is defined as anti-HBs titer greater than 10 mIU/ml after complete vaccination schedule. Aim The aim was to evaluate the efficacy of accelerated HB vaccine among students of Assiut Nursing School and College. Participants and methods This study included 100 students of Assiut Nursing School and College, and 10% of them had received only a single dose of HB vaccine previously (in the period 6–12 months before the study) but had not completed the vaccination schedule, and their prestudy anti-HBs titer was less than 10 mIU/ml. Prevaccination testing of HBs Ag, Anti-HBs, Anti-HBc IgG, and HCV-Ab was negative. A vaccination schedule of 0, 1, and 2 months was used. Then, anti-HBs were measured one month after the last vaccine dose to detect antibody response by third-generation ELISA. Results Postvaccination anti-HBs titer was significantly higher in comparison with its prevaccination level (4.072.62 before vs 66.44±11.61 after vaccination; P=0.01). The authors found that students receiving a single dose of HB vaccine in the period 6–12 months before the study had high anti-HBs titer either before the study (9.78±2.01) and after the study (179.50±40.11) in comparison with those not receiving a vaccine dose recently. Conclusion Seroprotection rate was 100%, that is, all enrolled participants show postvaccination anti-HBs titer greater than 10 mIU/ml, and students with a higher prevaccination anti-HBs titer had a higher postvaccination anti-HBs antibody titer.

Implementation of hepatitis B vaccine in high-risk young adults with waning immunity.

Universal hepatitis B (HB) vaccination among Thai newborns was initiated in 1992. The first dose of the monovalent HB vaccine was given at birth, then at months 2 and 6 simultaneously with the diphtheria-tetanus-pertussis whole-cell (DTPw) vaccine. In 2008, Thailand replaced the monovalent HB vaccine at months 2 and 6 with a combined DTP-HB given at months 2, 4, and 6, with an added monovalent HB vaccine at month 1 for infants whose mothers were HBV carriers. Despite this rigorous HB vaccination schedule, vaccinated infants who are now adolescents do not possess a protective level of anti-HB surface antigen (anti-HBs) (≥10 mIU/ml). Thus, many young adults may be rendered susceptible to HB infection. Our objective was to determine how HB booster vaccination may benefit high-risk adolescents. We evaluated the serological records of a cohort of medical students (n = 291), which showed that 271 students (93.1%) possessed anti-HBs less than the accepted protective level (<10 mIU/ml) and subsequently received the HB vaccine booster prior to medical school enrollment. We then examined the anti-HB surface antibody (anti-HBs) in 216 individuals six weeks after they were immunized. We found that 61%, 88%, and 94% of individuals with pre-booster anti-HBs of <1 mIU/ml, 1-<3 mIU/ml, and 3-<10 mIU/ml achieved protective anti-HBs, respectively. Post-booster geometric mean titers were 305, 513, and 1,929 mIU/ml in these groups and correlated with pre-booster anti-HBs titers. These data suggest that medical students with known anti-HBs <1 mIU/ml will benefit from 3 doses of HB vaccine at 0, 1, and 6 months. Students with anti-HBs 1-<10 mIU/ml would benefit from an HB vaccine booster without further anti-HBs evaluation.

ANTI HBS TITRE;

Introduction: The doctors and paramedical staff are at high risk of developingHepatitis B, infection. Hepatitis B vaccine is mandatory for medical students prior to admissionin medical colleges. After completion of vaccination determination of anti HBS is not in practice.All over the world some people remain non responders and don’t develop adequate antibodytitre essential for protection against hepatitis B virus. This study is therefore designed to estimatethe anti HBs titre among the medical students, who have completed three doses of hepatitisB vaccine. Objectives: To determine the serum anti HBs antibodies among the outgoing finalyear MBBS students who have received complete 03 doses of hepatitis B vaccine. StudyDesign: Descriptive cross sectional study. Place and Duration: This study was conductedfrom November 2010 to December 2015 at Biochemistry department Punjab Medical College incollaboration with Nawaz Medicare Hospital Faisalabad. Material and Methods: Two hundredand fifty nine female medical (MBBS) students from outgoing classes during the period ofNovember 2010 to December 2015 were enrolled in this study. All subjects were at the ageof 22-24 years at the time of sampling. Each received 03 doses of injection Engerix B, 10mcg/0.5ml each in a schedule of 0, 01, 06 months since the last 05 years. The blood sampleswere allowed to clot and serum was separated. The anti HBs and HBsAg were determined by3rd generation ELISA method. Results: A total 259 female medical students from outgoing finalyear MBBS classes were enrolled in this study. Among these subjects 48 (18.5%) had serumanti HBs levels &lt; 10 IU/L, 77 subjects (29.7%) have levels 10-20 IU/L, 116 subjects (44.8 %)have serum levels 21-100 IU/L, while 18 subjects (10%) have &gt; 100 IU/L serum anti HBs levels.Conclusion: The incidence of non responders and poor responders is higher among thevaccinees in this study as compared to foreign studies after five years of Hepatitis B vaccination.

English

Introduction: The doctors and paramedical staff are at high risk of developingHepatitis B, infection. Hepatitis B vaccine is mandatory for medical students prior to admissionin medical colleges. After completion of vaccination determination of anti HBS is not in practice.All over the world some people remain non responders and don’t develop adequate antibodytitre essential for protection against hepatitis B virus. This study is therefore designed to estimatethe anti HBs titre among the medical students, who have completed three doses of hepatitisB vaccine. Objectives: To determine the serum anti HBs antibodies among the outgoing finalyear MBBS students who have received complete 03 doses of hepatitis B vaccine. StudyDesign: Descriptive cross sectional study. Place and Duration: This study was conductedfrom November 2010 to December 2015 at Biochemistry department Punjab Medical College incollaboration with Nawaz Medicare Hospital Faisalabad. Material and Methods: Two hundredand fifty nine female medical (MBBS) students from outgoing classes during the period ofNovember 2010 to December 2015 were enrolled in this study. All subjects were at the ageof 22-24 years at the time of sampling. Each received 03 doses of injection Engerix B, 10mcg/0.5ml each in a schedule of 0, 01, 06 months since the last 05 years. The blood sampleswere allowed to clot and serum was separated. The anti HBs and HBsAg were determined by3rd generation ELISA method. Results: A total 259 female medical students from outgoing finalyear MBBS classes were enrolled in this study. Among these subjects 48 (18.5%) had serumanti HBs levels &lt; 10 IU/L, 77 subjects (29.7%) have levels 10-20 IU/L, 116 subjects (44.8 %)have serum levels 21-100 IU/L, while 18 subjects (10%) have &gt; 100 IU/L serum anti HBs levels.Conclusion: The incidence of non responders and poor responders is higher among thevaccinees in this study as compared to foreign studies after five years of Hepatitis B vaccination.

Long-term persistence in protection and response to a hepatitis B vaccine booster among adolescents immunized in infancy in the western region of China

ABSTRACT Objectives: To evaluate the persistence of protection from hepatitis B (HB) vaccination among adolescents immunized with a primary series of HB vaccine as infants, and the immune response to booster doses. Methods: Healthy adolescents aged 15–17 y vaccinated with HB vaccine only at birth were enrolled. Baseline serum hepatitis B surface antigen (HBsAg), antibody against hepatitis B surface antigen (anti-HBs) and antibody against hepatitis B core antigen (anti-HBc) were detected by Enzyme-Linked Immunosorbent Assay (ELISA) and anti-HBs level was measured using Chemiluminescent Microparticle Immunoassay (CMIA). The rate of HBV infection was calculated. The seroprotection rate of anti-HBs (≥ 10 mIU/ml) and GMC level were used to evaluate the persistence of immunity from HB vaccination. Those with anti-HBs < 10 mIU/ml were immunized with booster doses of HB vaccine and the anamnestic response was assessed. Results: Of 180 adolescents who received a primary series of HB vaccinations as infants, 3 (1.7%) had HBV infection and 74 (41.1%) had anti-HBs ≥ 10 mIU/ml with a GMC of 145.11 mIU/ml. The remaining 103 (57.2%) with anti-HBs < 10 mIU/ml received a booster dose of 20 μg HB vaccine and achieved the seroprotection rate of 84% (84/100) and a GMC of 875.19 mIU/ml at one month post-booster. An additional dose of 60 μg HB vaccine was administered to the 16 adolescents with anti-HBs < 10 mIU/ml after the first booster. All of them obtained anti-HBs seroprotection with a GMC of 271.02 mIU/ml at 1.5 months after an additional dose. Conclusions: Vaccine-induced immunity persisted for up to 15–17 y in 89.3% (158/177) of participants after a primary HB vaccination in infancy. Administering a booster dose of 20μg HB vaccine elicited an anamnestic immune responses in the majority of individuals with baseline anti-HBs <10 mIU/ml.

Vacunación frente a la hepatitis B. Impacto de los programas de vacunación tras 20 años de su utilización en España. ¿Es tiempo de cambios?

The highest incidence rate of hepatitisB (HB) in Spain is detected in adults between 20 and 54years old, whereas the incidence in children under 1year old is almost nil. The low prevalence of HB in children under 1year is mainly due to the success of gestational screening strategies for the detection of HBsAg(+) in pregnant women, and vaccination campaigns during childhood. Currently, in Spain, the last dose of the HB included in the national childhood immunization program is administered at 6months of age, although some studies show that delaying the age of the administration of the last dose of HB vaccine and increasing the time between doses, may improve immune memory by offering greater protection against this virus in the adulthood. In this article, the impact of HB vaccination in Spain is reviewed, and other potential vaccination strategies in our environment are discussed, such as extending the interval between doses, and administering the last dose in the second year of life, adapting the valid strategy in Spain to the current epidemiological context in order to reduce the prevalence of HB in adulthood.

Hepatitis B vaccination of healthcare workers at the Princess Marina Hospital, Botswana.

Batswana (i.e., the people of Botswana) healthcare workers (HCWs) are at high risk for occupational exposure to hepatitis B virus (HBV), thus the Botswana Ministry of Health recommends that HCWs should receive three doses of hepatitis B (HB) vaccine. However, there are no data on HB vaccination uptake by Batswana HCWs. This study investigated knowledge of, and attitudes towards, HB prevention and control, and predictors of HB vaccination uptake in HCWs at the Princess Marina Hospital during 2010. Self-administered questionnaires were distributed to doctors, nurses and laboratory workers (n=200). Knowledge was measured using 14 questions; attitude was measured using a 5-point Likert scale and 9 statements. Data on vaccination status and demographics were collected. Of the respondents, 17.2% (20/116) had good knowledge and 97.4% (113/116) had positive attitudes. At least one dose of HB vaccine had been received by 50.9% (59/116), while 31.0% (36/116) had received all three doses. Profession was the only predictor of HB vaccination uptake, with being a laboratory worker (OR=61.0) or a doctor (OR=51.5) predicting HB vaccination uptake with at least one dose. This is the first study on HB vaccination of Batswana HCWs, and shows that HB vaccination uptake is suboptimal.

Safety and Immunogenicity of Hepatitis B Vaccine: a Study on Iranian Navy Personnel

Preventing communicable diseases in the armed forces (AF) of a country is considered as a national interest and has a great importance. There are limited data on the efficacy of vaccination of the navy personnel. This study was designed to evaluate both the safety and the immunogenicity of a recombinant hepatitis B (HB) vaccine made by Pasteur Institute of Iran (IPI-rHB), in this target group. Methods: In this study, all members of two navy units were enrolled. After measuring their amount of primary antibody, the subjects were selected for vaccination. Finally, 108 male volunteers were surveyed who were all between 25 to 45 years of age. Three doses of IPI-rHB vaccine (1 ml containing 20µg of the recombinant antigen) were administered to the subjects who were serologically negative for HB markers. The vaccination was given intramuscularly via the deltoid muscle according to the 0, 1 and 6 months schedule. The subjects were carefully monitored to record any adverse reaction of the vaccine. Blood specimens were collected from each subject, 1 month after the second and third vaccinations, in order to determine the anti-HBs antibody response to the vaccine. The obtained serum was tested by ELISA to quantify anti-HBs antibodies raised in each subject. Results: The results showed that local pain, fever, erythema, induration, nausea, vomiting and headache were the significant side effects noted. Protective antibodies (anti-HBs) were detected with seroconversion and seroprotection rates of 52.9% and 47.1%, respectively after the second dose and seroconversion and seroprotection rates of 100% and 93.51% after the third dose of the vaccine. After completing the vaccination; in 101 (93.51%) of the participants, antibody level was greater than 10 mIU/ml and in 7 (6.48%) subjects, the antibody level was between 1 and 10 mIU/ml. After the vaccination, the geometric mean titer of anti-HB antibody was 132.85. The seroprotection rate was 93.51% among the vaccinated population and 6.48% of the participants showed seroconversion. In this study, 22 (20.37%) subjects had anti-HBs titer of 10-100 mIU/ml and 79% (73.15%) subjects had anti-HBs titer of greater than100 mIU/ml. Although immunity to HB was achieved to a protective level among all the participants, the assessment of the long term immunity in AF members after complete vaccination is recommended. Conclusion: the results emphasized the importance of HB vaccination in adults, especially the AF members. Moreover, it reinforced the fact that three doses of HB vaccine is necessary to increase the seropositivity rate of anti-HBsAg in this group.

Normal or defective immune response to Hepatitis B vaccine in patients with diabetes and celiac disease

A defective production of protective levels of antibodies to Hepatitis B (HB) vaccine is reported to occur in 4–10% of healthy subjects and a correlation with the presence of specific human leukocyte antigen (HLA) molecules, including DQ2, which also confers genetic predisposition to celiac disease (CD) and type I diabetes mellitus (T1DM), has been suggested. The aim of this study was to analyze the serological response to HB vaccine and measles-containing vaccines in 69 diabetic patients (T1DM), 42 patients with celiac disease (CD) and 79 healthy control subjects (CT). The median interval between the third dose of HB vaccine and serum collection was 6.8, 3.5, and 4.7 years for T1DM, CD and CT groups, respectively. 50/69 (72%) T1DM patients, 32/42 (76%) CD patients and 61/79 (77%) CT subjects showed protective anti-HBs antibodies after vaccination, with no statistically significant difference. On the contrary, a lower statistically significant difference was found in the mean HBsAb level of T1DM subjects when compared with the other two groups. No correlation between HLA DQ2 expression in T1DM and vaccine response was detected. The comparison of serological response to measles after vaccination also showed no statistically significant differences in the three groups. Contrasting results between these data and those reported in the literature might be due to differences in the time intervals between vaccination and testing. Prospective studies in pathological and healthy groups with the same age at HBV vaccination and with the same time interval for blood sample collection to determine antibody titers are necessary in order to provide more conclusive data.

The persistence of anti-HBs antibody and anamnestic response 20 years after primary vaccination with recombinant hepatitis B vaccine at infancy

Hepatitis B (HB) vaccine induces protective levels of antibody response (anti-HBs ≥ 10 mIU/mL) in 90–99% of vaccinees. The levels of anti-HBs antibody decline after vaccination. The aim of this study was to evaluate the persistence of anti-HBs antibodies and immunologic memory in healthy adults at 20 years after primary vaccination with recombinant HB vaccine. Blood samples were collected from 300 adults at 20 years after primary HB vaccination and their sera were tested for anti-HBs antibody by ELISA technique. A single booster dose of HB vaccine was administered to a total of 138 subjects, whose anti-HBs antibody titer was <10 mIU/mL. The sera of subjects were re-tested for the anti-HBs antibody levels at 4 weeks after booster vaccination. At 20 years after primary vaccination 37.0% of participants had protective levels of antibody with geometric mean titer (GMT) of 55.44 ± 77.01 mIU/mL. After booster vaccination, 97.1% of vaccinees developed protective levels of antibody and the GMT rose from 2.35 ± 6.49 mIU/mL to 176.28 ± 161.78 mIU/mL. 125/138 (90.6%) of re-vaccinated subjects also showed an anamnestic response to booster vaccination. At 20 years after primary vaccination with HB vaccine, low proportion of the subjects had protective levels of antibody. However, the majority of the re-vaccinated subjects developed protective levels of anti-HBs and showed an anamnestic response after booster vaccination. Additional follow-up studies are necessary to determine the duration of immunological memory.

Neuroinfections due to Haemophilus influenzae in Slovakia: From endemic to sporadic disease

Background: The World Health Organization (WHO) has identified hepatitis B (HB) as a major global health problem, estimating that globally there are 2 billion people who have been exposed to hepatitis B virus (HBV) infection (WHO, 2012). Healthcare workers (HCWs) are at an increased risk of being infected with HBV since they may be exposed to blood and blood by-products. It is therefore highly recommended that they should be vaccinated against HBV. But even though the Gauteng Department of Health and Social Development have published interim protocols (IPs) recommending that HCWs should be vaccinated, this is done on a voluntary basis and previous studies have shown that the uptake of the HBV vaccine is low among Gauteng HCWs. This study aimed to investigate the HB vaccination coverage of HCW’s at CHBH. This was a quantitative descriptive study which made use of a self-administered questionnaire with closed ended questions, distributed to 400 HCWs (100 doctors and 300 nurses) at Chris Hani Baragwanath Hospital (CHBH), Johannesburg, Gauteng Province. Methods&Materials: Thiswas a quantitative descriptive study which made use of a self-administered questionnaire with closed ended questions, distributed to 400 HCWs (100 doctors and 300 nurses) at CHBH hospital. Results: The overall response rate was 86.3% (345/400). Of the respondents, 55.7% (192/345) had received at least one dose of HB vaccine, andonly15.4% (53/345)were fullyvaccinatedwith threeor more HB vaccination doses. Most HCWs were not fully vaccinated, with 15.4% (53/345) having received three or more doses. A higher proportion (26.7% [23/86]) of doctors than nurses (11.6% [30/259]) had received three or more doses. Of those who had received at least one dose of HB vaccine, the majority (80% [154/192]) had not received 3 doses of HB vaccination. Conclusion: The Department of Health and Social Development in Gauteng Province highly recommends that HCWs should be vaccinated against HBV unfortunately vaccination is done on a voluntary basis. It is strongly recommended that HB vaccination for HCWs should be legislated in SA in order to increase vaccination coverage for the benefit of both the patient and HCW.

Hepatitis B vaccination coverage of healthcare workers at Chris Hani Baragwanath hospital, Gauteng Province, South Africa

Background: The World Health Organization (WHO) has identified hepatitis B (HB) as a major global health problem, estimating that globally there are 2 billion people who have been exposed to hepatitis B virus (HBV) infection (WHO, 2012). Healthcare workers (HCWs) are at an increased risk of being infected with HBV since they may be exposed to blood and blood by-products. It is therefore highly recommended that they should be vaccinated against HBV. But even though the Gauteng Department of Health and Social Development have published interim protocols (IPs) recommending that HCWs should be vaccinated, this is done on a voluntary basis and previous studies have shown that the uptake of the HBV vaccine is low among Gauteng HCWs. This study aimed to investigate the HB vaccination coverage of HCW’s at CHBH. This was a quantitative descriptive study which made use of a self-administered questionnaire with closed ended questions, distributed to 400 HCWs (100 doctors and 300 nurses) at Chris Hani Baragwanath Hospital (CHBH), Johannesburg, Gauteng Province. Methods&Materials: Thiswas a quantitative descriptive study which made use of a self-administered questionnaire with closed ended questions, distributed to 400 HCWs (100 doctors and 300 nurses) at CHBH hospital. Results: The overall response rate was 86.3% (345/400). Of the respondents, 55.7% (192/345) had received at least one dose of HB vaccine, andonly15.4% (53/345)were fullyvaccinatedwith threeor more HB vaccination doses. Most HCWs were not fully vaccinated, with 15.4% (53/345) having received three or more doses. A higher proportion (26.7% [23/86]) of doctors than nurses (11.6% [30/259]) had received three or more doses. Of those who had received at least one dose of HB vaccine, the majority (80% [154/192]) had not received 3 doses of HB vaccination. Conclusion: The Department of Health and Social Development in Gauteng Province highly recommends that HCWs should be vaccinated against HBV unfortunately vaccination is done on a voluntary basis. It is strongly recommended that HB vaccination for HCWs should be legislated in SA in order to increase vaccination coverage for the benefit of both the patient and HCW.

The impact of hepatitis B vaccine in China and in the China GAVI Project

The China GAVI Project (CGP) was initiated in 2002 to provide hepatitis B (HB) vaccine to infants born in the less developed areas of China including the Western provinces and poverty counties of Middle provinces, to prevent the consequences of hepatitis B virus infection. By 2009, the project areas had raised coverage of 3 doses of HB vaccine and timely birth doses to almost 90% among infants, comparable to those in wealthier Eastern provinces, and reduced HBV prevalence to <1% among children in these areas. We estimated the impact in disease prevented by HB vaccine in China between 1992, when the vaccine was routinely recommended, and 2009, and in CGP areas for the years 2003–2009, when the CGP was active. A published model was used to estimate the burden of chronic and acute HBV infection and death prevented due to HB vaccination in China and the CGP areas using data from national serosurveys in China in 1992 and 2006, and HB vaccine coverage from surveys in 2004, 2006 and 2010. We used sigmoid modeling to estimate vaccine coverage nationally, regionally, and CGP areas. We also estimated the incremental impact of the CGP on HB vaccine coverage in those underserved areas. Our findings suggest that between 1992 and 2009, HB vaccination in China has prevented 24million chronic HBV infections and 4.3million future deaths due to cirrhosis, hepatocellular carcinoma and acute hepatitis. During the CGP between 2003 and 2009, an estimated 3.8million chronic HBV infections and 680,000 deaths were prevented in CGP areas. We found that the CGP funding increased HB vaccine coverage in project areas by 4–15% for HB3 and 4–27% for timely birth dose beyond the coverage expected without the CGP. The CGP represents a highly successful public health collaboration between the national government and international partners.

Knowledge and practice of standard precautions in public health facilities in Abuja, Nigeria

Adherence to standard precautions is poor in public health facilities in resource-limited settings due to higher disease prevalence and limited organizational support. The practice of standard precautions among Health Care Workers (HCWs) in public health facilities in Abuja, Nigeria was evaluated. A cross-sectional survey of 277 HCWs was conducted using a structured questionnaire. Of 277 participants, 83(29.96%) were doctors; 194(70.04%) were nurses. Median age (years) of doctors was 34(IQR: 30, 39), while nurses was 39(IQR: 33; 45). Median years of experience for doctors was 7(IQR: 4; 10) while nurses was 15(IQR: 9; 20). 16.61% participants had knowledge of the basic concept of standard precautions. 42.24% knew potential sources of occupational exposure. The association between the knowledge and area of practice was significant (p=0.011). 97.46% practiced hand washing; 97.83% reported regular use of hand gloves; 88.44% use gown or plastic apron; 68.95% use masks and eye protector. The major factor reported for non-adherence was non-availability of the materials. Practice of recapping used needle was common among doctors than nurses (p=0.01). 32.53% of doctors and 28.87% of nurses had ≥1 dose of hepatitis-B vaccine; the difference in hepatitis-B immunization status of doctors and nurses was not significant (p=0.556). The knowledge of standard precautions among HCWs was suboptimal. Except for mask and eye protector, the use of PPE was good. Non-availability of materials was the major cause of poor compliance. The HCWs hepatitis-B vaccination status was poor. Capacity development of HCWs and a comprehensive infection prevention and control program were recommended.

Protective effect of hepatitis B vaccine combined with two-dose hepatitis B immunoglobulin on infants born to HBsAg-positive mothers.

BackgroundDespite the use of hepatitis B (HB) vaccine and hepatitis B immunoglobulin (HBIG), a portion of infants are still non- or low-responders, or even immunoprophylaxis failure. We aimed to determine the immune response in the infants from the mothers being positive for hepatitis B surface antigen (HBsAg), by which the infants received three doses of HB vaccine in combination with two-dose 200 IU HBIG injections.MethodsIn this retrospective study, 621 infants from HBsAg-positive mothers in Beijing YouAn Hospital between January 2008 and December 2009 were included. All the infants were given three doses of 10 µg HB vaccine (at 0, 1 and 6 months of age) and two-dose of 200 IU HBIG (at birth and in 2 weeks of age). Serum HBsAg and antibody to HBsAg (anti-HBs) in all the infants were determined at 7 months of age.ResultsOf the 621 infants, 2.9% were immunoprophylaxis failure (positive for HBsAg), 1.4% were non-responders (anti-HBs undetectable), 95.7% were responders. The 594 responders could be categorized into three subsets, 22 were 10 to 99 IU/L for anti-HBs levels, 191 were 100 to 999 IU/L, and 381 were ≥1000 IU/L. The immunoprophylaxis failure rate was at 0% and 5.2% for the infants of HBeAg-negative and HBeAg-positive mothers(P<0.001). Infants from mothers with detectable HBV DNA had higher incidence of immunoprophylaxis failure than those of mothers without detectable HBV DNA (P = 0.002). The factors including gender, birth weight, gestation weeks, the rates of maternal HBeAg-positive, and detectable HBV DNA did not contribute to the no response to HB vaccination.ConclusionsThrough vaccination by three doses of HB and two-dose of HBIG, majority of the infants (95.7%) achieved a protective level of anti-HBs at 7 months of age. Maternal HBeAg-positive and HBV DNA detectable were associated with the immunoprophylaxis failure, but not contribute to the non- or low-response to HB vaccination.