Long-Term Persistence of Seroprotection by Hepatitis B Vaccination in Healthcare Workers of Southern Italy

Abstract

BackgroundThe impact of hepatitis B virus (HBV) vaccination campaigns on HBV epidemiology needs to be evaluated, in order to assess the long-term immunity offered by vaccines against HBV.ObjectivesTo evaluate the current status of anti-HBV vaccine coverage among healthcare workers (HCWs) in Southern Italy, and to determine the long-term persistence of antibodies to hepatitis B surface antigens (anti-HBs) in such a cohort of subjects.Patients and MethodsA longitudinal, retrospective seroepidemiological survey was conducted among 451 HCWs, who were working at or visiting, the Occupational Health Department of a city hospital, in Catania, Italy, between January 1976 and December 2010.ResultsAt the 30-year follow-up (mean follow-up 10.15 ± 5.96 years, range 0.74-30), 261 HCWs had detectable anti-HBs titers indicating a persistence of seroprotection of 89.4% (out of 292 anti-HBs positive results, three months after vaccination). An inadequate vaccination schedule was the strongest predictor of antibody loss during follow-up (OR = 8.37 95% CI: 5.41-12.95, P < 0.001). A Kaplan-Maier survival curve revealed that the persistence of anti-HBs 30 years after vaccination, was 92.2% for high responders, while it was only 27.3% for low responders (P = 0.001).ConclusionsA good level of seroprotection persisted in 57.9% of the subjects after 30 years. Factors related to this immunization status confirmed the importance of vaccinating HCWs early in their careers and ensuring an adequate vaccination schedule. However, with particular reference to the low rate of hepatitis B vaccine coverage among HCWs in Southern Italy, the implementation of a new educational intervention as part of an active vaccination program is needed.

Coverage and Long-Term Immunogenicity of Hepatitis B Vaccine in Healthcare Workers

“…The current study did not find any association between age and adequate response; these results were in agreement with those of other studies conducted in Iran, Italy and South Asia (20,21,28,29). Some studies in Japan and Europe found that anti-HBs level decreases with age (26,30).…”

“…According to the current study results, 5.6% of HCWs did not develop a protective level after the first series, and inadequate immunity after the second series of vaccination was less than 1%, which was lower than those of similar studies in Poland (12.2%), Sri Lanka (9.9%) and Italy (11.6%) (20)(21)(22).…”

Molecular identification of hepatitis B virus genotypes/subgenotypes: Revised classification hurdles and updated resolutions

“…Protective serum titers of anti-HBs (greater than 10 IU/L) develop in 95%-99% of healthy infants, children [101,102] and young adults [103] . Many studies have demonstrated that HBV vaccination has dramatically decreased the HBV chronicity rates and HBV-related complications [7] .…”

Association between Waste Management and HBV among Solid Municipal Waste Workers: A Systematic Review and Meta‐Analysis of Observational Studies

“…The immunization of workers reduces their susceptibility to infection and infections' number. Long-term immunity offered by vaccines against HBV was recently reported in 50% of health workers 30 years after vaccination [7]. …”