Discordance of hepatitis B vaccination policies for healthcare workers between the USA, the UK, and Germany

Komatsu, Haruki; Klenerman, Paul; Thimme, Robert

doi:10.1111/hepr.13470

Cited by 8 publications

(8 citation statements)

References 54 publications

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“…It is well documented that after primary HBV immunization, anti-HBs concentrations slowly decline and about 15-50% of vaccinated children will have low or undetectable concentrations of anti-HBs 5-15 years after vaccination [18].…”

Section: Discussionmentioning

confidence: 99%

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Kinetics of Anti-Hepatitis B Surface Antigen Titers in Nurse Students after a Two-Year Follow-Up

et al. 2020

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Infection caused by hepatitis B virus (HBV) can be prevented through a safe and effective vaccine. This study analysed the kinetics of serum antibodies against hepatitis B surface antigen (HBsAg) (anti-HBs) titers in relation to previous vaccine boosters in Italian nursing students who were followed up for two years. Serum anti-HBs titers were evaluated at the first visit, after vaccine booster (if required) and at visit after two years. Overall, 483 students (mean age = 21.7 years; SD = 3.7) with median anti-HBs IgG titer of 6 mUI/mL (interquartile range (IQR) = 0–34) were enrolled. A total of 254 (52.5%) students with a titer lower than 10 mIU/mL were offered an anti-HBV booster at the first visit. Among these students, an exponential relation between anti-HBs IgG titer, one month after HBV booster and anti-HBs IgG titer two years later was found (y = 3.32 exp (0.0045x); R2 = 0.48; p < 0.001). Students with anti-HBV titer higher than 10 mIU/mL (N = 229) were followed up, and anti-HBs IgG titers at follow-up visit linearly correlated with anti-HBV baseline titers (y = 0.86x + 26.2; R2 = 0.67; p < 0.001). A decrease in anti-HBs titers can be expected a few years after the anti-HBV booster dose. This reduction is more pronounced than that observed in students not administered the booster dose and is exponential with respect to basal titers assessed after the booster dose.

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Section: Discussionmentioning

confidence: 99%

“…However, there is a common agreement that a responder to the primary dose should be considered protected despite the actual antibody titer [6]. In the past several years, the international scientific community has raised a debate about the need for a booster dose [18].…”

Section: Introductionmentioning

confidence: 99%

Kinetics of Anti-Hepatitis B Surface Antigen Titers in Nurse Students after a Two-Year Follow-Up

et al. 2020

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“…28 Furthermore, students with anti-HBs antibody titers of 10 to <100 mIU/ml, being a highrisk group of health care workers, are advised one booster dose of HBV vaccine according to the United Kingdom and Germany policy for health care workers. 29 These policies consider an anti-HBs titer !100 mIU/ml a successful vaccination. Highly significant differences were observed between the mean baseline and postrevaccination antibody titers in both genders in the present study with higher levels reported postrevaccination.…”

Section: Discussionmentioning

confidence: 99%

Seroprotection of Hepatitis B Vaccine in Dental Students Two Decades after Infant Immunization and the Possible Need for Revaccination

Lingawi

Afifi

2022

Eur J Dent

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Objectives This study aimed to assess hepatitis B surface antibody (anti-HBs) persistence among dental students two decades after infant vaccination and immune response after revaccination or booster dose in nonimmune groups. Materials and Methods A cross-sectional study was performed using laboratory reports for anti-HBs performed to dental students at the Umm al-Qura University from 2016 to 2020. Reports were classified according to baseline antibody titer into group I (titer <10 mIU/mL), group II (titer 10 to <100 mIU/mL), and group III (titer ≥100 mIU/mL). The basal antibody titer of each group was correlated to student's gender and birth year and compared with postrevaccination or booster dose titer in groups I and II. Statistical Analysis Data of baseline and postrevaccination anti-HBs antibody titers were analyzed using Statistical Package for Social Science (SPSS). One-way ANOVA was used to compare between different means for antibody titers of students as well as baseline and postrevaccination antibody levels for nonimmune students with nonprotective antibody titers. Pairwise multiple comparison of the difference between baseline and postrevaccination anti-HBs antibody titers were done by post hoc Tukey's honestly significant difference (HSD) test. Chi-squared test was used for comparing between the frequencies. A p-Value of ≤0.05 was considered significant and p < 0.01 was considered highly significant. Results A significant percentage (73.6%) of students had antibody titer <10 mIU/mL, while only 4.8% had antibody titer ≥100 mIU/mL with nonsignificant difference between both genders (χ 2 =3.784, p = 0.151). A statistically nonsignificant difference was also found between the three categories of anti-HBs antibody titers among students with different birth dates (χ 2 = 13.817, p = 0.182). After revaccination of nonimmune students, 100% of them showed strongly protective antibody titers with mean of 842.88 to 844.58 mIU/mL. A highly significant difference was observed between the mean baseline and postrevaccination antibody titers in both genders, with a higher mean of post revaccination (p = 0.000). Conclusion Two decades after infant immunization, a significant percentage of dental students failed to maintain the anti-HBs seroprotective titer. So titer measurement should be made compulsory before they begin their clinical training and revaccination or booster dose should be given to nonimmune students to maintain a high protection level.

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“…Health care staff comprise one of these groups, with a 2-10 times higher risk of infection than the general population. Transmission generally occurs through accidental exposure to patients' blood, primarily as a result of parenteral procedures [3,11,18,20,25].…”

Section: Scientific Background and Rationalementioning

confidence: 99%

Vaccination adjuvated against hepatitis B in Spanish National Healthcare System (SNS) workers typed as non-responders to conventional vaccines

Bravo-Grande

Blanco-González

Torre-Robles

et al. 2021

Vaccine

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An interventional, phase 4, single group assignment, without masking (open label), preventive clinical trial was carried out in health workers with biological risk in their tasks, who have been filed as non-responders to conventional vaccination against Hepatitis B. Methods: 67 health workers with biological risk in their tasks, who have been filed as non-responders to conventional vaccination against Hepatitis B, were enrolled in the Clinical Trial. All participants were from 18 years up to 64 years old. Inclusion Criteria: NHS workers -including university students doing their internships in health centres dependent on the National Health System (inclusion of students is regulated and limited by specific instructions on labour prevention in each autonomous community)-classified as non-responders. The criteria defining them as non-responders to the conventional hepatitis B vaccine is anti HBsAb titers < 10 mUI/ml following the application of six doses of conventional vaccine at 20 lg doses (two complete guidelines). The objective of this study was to provide Health workersstaff with an additional protection tool against hepatitis B infection, and to evaluate the efficacy of the adjuvanted vaccine in healthy non-responders to conventional hepatitis B vaccine. The primary outcome was the measurement of antibody antiHBs before the first Fendrix Ò dose and a month after the administration of each dose. Other outcome was collection of adverse effects during administration and all those that could be related to the vaccine and that occur within 30 days after each dose. In this study, only one group was assigned. There was no randomization or masking. Results: The participants were recruited between April 13, 2018 and October 31, 2019. 67 participants were enrolled in the Clinical Trial and included the analyses. The primary immunisation consists of 4 separate 0.5 ml doses of Fendrix Ò , administered at the following schedule: 1 month, 2 months and 6 months from the date of the first dose. Once the positivity was reached in any of the doses, the participant finished the study and was not given the following doses. 68.66% (46 out 67) had a positive response to first

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Discordance of hepatitis B vaccination policies for healthcare workers between the USA, the UK, and Germany

Cited by 8 publications

References 54 publications

Kinetics of Anti-Hepatitis B Surface Antigen Titers in Nurse Students after a Two-Year Follow-Up

Kinetics of Anti-Hepatitis B Surface Antigen Titers in Nurse Students after a Two-Year Follow-Up

Seroprotection of Hepatitis B Vaccine in Dental Students Two Decades after Infant Immunization and the Possible Need for Revaccination

Vaccination adjuvated against hepatitis B in Spanish National Healthcare System (SNS) workers typed as non-responders to conventional vaccines

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