Hepatitis B and Anti-HBS vaccination among health workers

AbstractObjectiveTo evaluate Hepatitis B vaccination coverage and its associated factors among health workers.MethodologyIt is a cross-sectional study conducted with 506 primary care and medium complexity health workers in a municipality of the ‘Recôncavo’ region of Bahia state, Brazil. A questionnaire was applied to assess the vaccination status for Hepatitis B and the sociodemographic and occupational characteristics of health workers. Univariate and bivariate analyses were used to evaluate the factors associated with vaccination.ResultsThe population studied was predominately female (78.3%) composed of individuals with steady employment (63.8%) and who rated themselves in good or very good health (78.1%). The majority reported having received three doses of the vaccine against Hepatitis B (59.9%). Nurses, technicians, and physicians were the most immunized (91.8%). The following factors were associated with self-reported Hepatitis B vaccination: sex, age, educational level, use of individual protection equipment (IPE), and contact with biological material.DiscussionA low coverage of complete Hepatitis B vaccination was observed (59.9%). Health professionals who did not develop an adequate level of antibodies after vaccination should be encouraged to complete a fourth dose (booster).ConsiderationsThose without immunity should be informed of their susceptibility to VHB until they present evidence of immune response. Biosecurity should be incorporated into academic curriculums to create positive attitudes regarding adhesion to vaccination.

研究摘要
目的：评估巴西巴伊亚州雷孔卡沃地区某市镇内医疗卫生工作者的乙型肝炎（Hepatitis B）疫苗接种覆盖率及其相关影响因素。
方法：本研究为横断面研究，共纳入506名来自基层医疗与中等复杂度医疗机构的医疗卫生工作者。通过问卷调研评估受试者的乙型肝炎疫苗接种状况，以及其社会人口学与职业特征。采用单因素与双因素分析方法，探究与疫苗接种相关的影响因素。
结果：受试人群以女性为主（78.3%），多数拥有稳定就业状态（63.8%）且自评健康状况为良好或极佳（78.1%）。大部分受试者报告已完成三剂乙型肝炎疫苗接种（59.9%），其中护士、医技人员与医师的免疫覆盖率最高，达91.8%。与自我报告的乙型肝炎疫苗接种情况显著相关的因素包括：性别、年龄、受教育程度、个人防护装备（Individual Protection Equipment, IPE）使用情况以及生物材料接触史。
讨论：本研究观察到乙型肝炎疫苗全程接种覆盖率偏低（59.9%）。建议对接种后未产生足够抗体水平的医疗卫生专业人员追加第四剂加强疫苗（booster）。
思考与建议：应告知无免疫应答的受试者其对乙型病毒性肝炎（Viral Hepatitis B, VHB）的易感性，直至其获得明确的免疫反应检测结果。需将生物安全相关内容纳入医学教育课程，以培养医疗卫生工作者对疫苗接种的积极依从态度。