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Persistence of Antibody in Healthcare Workers Vaccinated Against Hepatitis B

Published online by Cambridge University Press:  21 June 2016

Alan C. Street ,
Teresa Z. Weddle ,
Wayne R. Thomann ,
Ellen W. Lundberg ,
George W. Jackson  and
John D. Hamilton
Alan C. Street
Affiliation:
Department of Medicine, Durham VA Medical Center, Duke University Medical Center, Durham, North Carolina Department of Medicine, Duke University Medical Center, Durham, North Carolina
Teresa Z. Weddle
Affiliation:
Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina
Wayne R. Thomann
Affiliation:
Department of Environmental Safety, Duke University Medical Center, Durham, North Carolina
Ellen W. Lundberg
Affiliation:
Department of Radiology, Duke University Medical Center, Durham, North Carolina
George W. Jackson
Affiliation:
Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina
John D. Hamilton*
Affiliation:
Department of Medicine, Durham VA Medical Center, Duke University Medical Center, Durham, North Carolina Department of Medicine, Duke University Medical Center, Durham, North Carolina
*
Infectious Diseases, Department of Veterans' Affairs Medical Center, 508 Fulton Street, Durham, NC 27705
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Abstract

A cross-sectional serological survey was undertaken in 82 randomly selected high-risk healthcare workers previously vaccinated with the hepatitis B vaccine. The study design allowed for the identification and testing for hepatitis B surface antibody in equal numbers of employees in six-month intervals up to five years after vaccination. The results showed a consistent decline in antibody level with time, and an increasing proportion of participants with antibody levels below the commonly accepted protective level of ≥10 S/N (sample counts/negative control counts) radioimmunoassay units. The percent of vaccinees whose S/N ratio was greater than 10 fell from 10% at one year, to 25% at two years, to over 50% at four years. Based on these figures, as well as the financial costs of hepatitis B in employees and the predictability of booster immunization, it was possible to assess the cost benefit of a hospital policy for reimmunization. At our institution, a strategy of revaccination at fixed intervals could save up to $200,000 over a ten-year period if revaccination was not offered and vaccine efficacy declined. The information obtained should help determine the need for revaccination and the advantages and disadvantages of alternative revaccination strategies.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 11 , Issue 10 , October 1990 , pp. 525 - 530
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1990 

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References

1. Inactivated hepatitis B virus vaccine: recommendations of the Immunization Practices Advisory Committee. MMWR. 1982;31:317–328.Google Scholar
2. Stevens, CE, Taylor, PE, Tong, MJ, Toy, PT, Vyas, GN. Hepatitis B vaccine: an overview. In: Vyas, GN, Dienstag, JL, Hoofnagle, JH, eds. Viral Hepatitis and Liver Disease. Orlando, Fla: Grune and Stratton; 1984:275–291.Google Scholar
3. McLean, AA, Hilleman, MR, McAleer, WJ, Buynak, EB. Summary of worldwide clinical experience with H-B-VaxR (B,MSD). J Infect. 1983;7(suppl):95–104.10.1016/S0163-4453(83)96879-2CrossRefGoogle ScholarPubMed
4. Recommendations of the Immunization Practices Advisory Committee: protection against viral hepatitis. MMWR. 1990;39:1–26.Google Scholar
5. Hamilton, JD. Hepatitis B virus vaccine: an analysis of its potential use in medical workers. JAMA. 1983;250:2145–2150.10.1001/jama.1983.03340160031027CrossRefGoogle ScholarPubMed
6. Heyward, WL, Bender, TR, McMahon, BJ, et al. The control of hepatitis B virus infection with vaccine in Yupik Eskimos. Am J Epidemiol. 1985;121:914–923.10.1093/oxfordjournals.aje.a114061CrossRefGoogle ScholarPubMed
7. Denis, F, Mounier, M, Hessel, L, et al. Hepatitis B vaccination in the elderly. J Infect Dis. 1984;149:1019.10.1093/infdis/149.6.1019CrossRefGoogle ScholarPubMed
8. Keys, A, Fidanza, F, Karvonen, MJ, et al. Indices of relative weight and obesity. J Chronic Dis. 1972;25:329–343.10.1016/0021-9681(72)90027-6CrossRefGoogle ScholarPubMed
9. Francis, DP, Hadler, SC, Thompson, SE, et al. The prevention of hepatitis B with vaccine. Report of the Centers for Disease Control Multi-Center efficacy trial among homosexual men. Ann Intern Med. 1982;97:362–366.10.7326/0003-4819-97-3-362CrossRefGoogle ScholarPubMed
10. Hadler, SC, Francis, DP, Maynard, JE, et al. Long-term immunogenicity and efficacy of hepatitis B vaccine in homosexual men. N Engl J Med. 1986;315:209–214.10.1056/NEJM198607243150401CrossRefGoogle ScholarPubMed
11. Szmuness, W, Stevens, CE, Harley, EJ, et al. Hepatitis B vaccine. Demonstration of efficacy in a controlled clinical trial in a high-risk population in the United States. N Engl J Med. 1980;303:833–841.10.1056/NEJM198010093031501CrossRefGoogle Scholar
12. Szmuness, W, Stevens, CE, Zang, EA, Harley, EJ, Kellner, A. A controlled clinical trial of the efficacy of the hepatitis B vaccine (Heptavax B): a final report. Hepatohgy. 1980;1:377–385.10.1002/hep.1840010502CrossRefGoogle Scholar
13. Gibas, A, Watkins, E, Hinkle, C, Dienstag, JL. Long-term persistence of protective antibody after hepatitis B vaccination of healthy adults. In: Zuckerman, A, ed. Viral Hepatitis and Liver Disease. New York, NY: Alan Liss Inc; 1988:998–1001.Google Scholar
14. Jilg, W, Schmidt, M, Deinhardt, F, Zachoval, R. Hepatitis B vaccination: how long does protection last? Lancer. 1984;2:458.10.1016/S0140-6736(84)92926-XCrossRefGoogle ScholarPubMed
15. Jilg, W, Schmidt, M, Zachoval, R, Deinhardt, F. Persistence of antibodies against hepatitis B surface antigen after vaccination against hepatitis B (English translation). Deutsch Medizinische Wochenschrift. 1985;110:205–209.10.1055/s-2008-1068799CrossRefGoogle Scholar
16. Horowitz, MM, Ershler, WB, McKinney, WP, Battiola, JR. Duration of immunity after hepatitis B vaccination: efficacy of low-dose booster vaccine. Ann Intern Med. 1988;108:185–189.10.7326/0003-4819-108-2-185CrossRefGoogle ScholarPubMed
17. Collier, AC, Corey, L, Murphy, VL, Handsfield, HH. Antibody to human immunodeficiency virus (HIV) and suboptimal response to hepatitis B vaccination. Ann Intern Med. 1988;109:101–105.10.7326/0003-4819-109-2-101CrossRefGoogle ScholarPubMed
18. Weber, DJ, Rutala, WA, Samsa, GP, Bradshaw, SE, Lemon, SM. Impaired immunogenicity of hepatitis B vaccine in obese persons. N Engl J Med. 1986;314:1393.Google ScholarPubMed
19. Strickler, A. Hepatitis B vaccine. N Engl J Med. 1987; 316:47.Google Scholar
20. Alter, MJ, Favero, MS, Francis, DP. Cost benefit of hepatitis B vaccination in hemodialysis centers. J Infect Dis. 1983;148:770–771.10.1093/infdis/148.4.770aCrossRefGoogle ScholarPubMed
21. Lahaye, D, Strauss, P, Baleux, C, van Ganse, W. Cost-benefit analysis of hepatitis B vaccination. Lancet. 1987;2:441–442.10.1016/S0140-6736(87)90971-8CrossRefGoogle ScholarPubMed