Post-vaccination anti-HBs testing among healthcare workers: More economical than post-exposure management for Hepatitis B

Abstract

<jats:p> Objective: to compare the direct cost, from the perspective of the Unified Health System, of assessing the post-vaccination serological status with post-exposure management for hepatitis B among health care workers exposed to biological material. Method: cross-sectional study and cost-related, based on accident data recorded in the System of Information on Disease Notification between 2006 and 2016, where three post-exposure and one pre-exposure management scenarios were evaluated: A) accidents among vaccinated workers with positive and negative serological status tests for hepatitis B, exposed to known and unknown source-person; B) handling unvaccinated workers exposed to a known and unknown source-person; C) managing vaccinated workers and unknown serological status for hepatitis B and D) cost of the pre-exposure post-vaccination test. Accidents were assessed and the direct cost was calculated using the decision tree model. Results: scenarios where workers did not have protective titles after vaccination or were unaware of the serological status and were exposed to a positive or unknown source-person for hepatitis B. Conclusion: the direct cost of hepatitis B prophylaxis, including confirmation of serological status after vaccination would be more economical for the health system.</jats:p>

Serological and vaccine evaluation for hepatitis B among Community Health Workers

“…The cost of implementing testing for anti-HBs after completion of the regimen is low compared to post-exposure prophylactic management of HBV 19 . In addition, health care facilities that jointly adopt anti-HBs testing in surveillance programs and the vaccine have higher HCW vaccination coverage than facilities that do not offer the test 20 .…”

“…Antibody detection ≥ 10 milli-international units (mUI)/ mL ensures lifelong worker protection (17) ; however, studies show low adherence to this test by Brazilian HCWs (11,18) . The cost of implementing testing for anti-HBs after completion of the regimen is low compared to postexposure prophylactic management of HBV (19) . In addition, health care facilities that jointly adopt anti-HBs testing in surveillance programs and the vaccine have higher HCW vaccination coverage than facilities that do not offer the test (20) .…”

Evaluación serológica y vacuna para la hepatitis B entre Agentes Comunitarios de Salud

“…La detección de anticuerpos ≥ 10 milliinternational units (mUI)/mL garantiza la protección del trabajador a lo largo de la vida (17) ; sin embargo, estudios retratan baja adhesión a la realización de ese examen por los TS brasileños (11,18) . El costo de la implementación del test para anticuerpos contra el anti-HBs después de la finalización del programa es bajo comparado al manejo profiláctico, después de la exposición al VHB (19) . Además de eso, las instituciones de la salud que adoptan conjuntamente la realización del test anti-HBs y la vacuna, en los programas de vigilancia, poseen mayores coberturas de vacunación de los TS que los establecimientos que no ofrecen el test (20) .…”

Avaliação sorológica e vacinal para hepatite B entre Agentes Comunitários de Saúde

“…A detecção de anticorpos ≥ 10 milli-international units (mUI)/mL garante proteção ao trabalhador ao longo da vida (17) ; todavia estudos retratam baixa adesão da realização desse exame pelos TS brasileiros (11,18) . O custo da implementação do teste para anticorpos contra o antígeno de superfície do vírus da hepatite B (anti-HBs) após completude do esquema é baixo comparado ao manejo profilático pós-exposição ao vírus da hepatite B (19) . Além disso, instituições de saúde que adotam juntamente o teste anti-HBs nos programas de vigilância e a vacina possuem maiores coberturas vacinais de TS do que os estabelecimentos que não oferecem o exame (20) .…”