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Immunity Against Infectious Diseases Predictive Value of Self-Reported History of Vaccination and Disease

Published online by Cambridge University Press:  02 January 2015

Andrea Trevisan ,
Clara Frasson ,
Marta Morandin ,
Michela Beggio ,
Alberto Bruno ,
Elisabetta Davanzo ,
Livio Di Marco ,
Livio Simioni  and
Guglielmo Amato
Andrea Trevisan*
Affiliation:
Department of Environmental Medicine and Public Health, University of Padua, Padua
Clara Frasson
Affiliation:
Department of Environmental Medicine and Public Health, University of Padua, Padua
Marta Morandin
Affiliation:
Department of Environmental Medicine and Public Health, University of Padua, Padua
Michela Beggio
Affiliation:
Department of Environmental Medicine and Public Health, University of Padua, Padua
Alberto Bruno
Affiliation:
Department of Environmental Medicine and Public Health, University of Padua, Padua
Elisabetta Davanzo
Affiliation:
Department of Environmental Medicine and Public Health, University of Padua, Padua
Livio Di Marco
Affiliation:
Department of Environmental Medicine and Public Health, University of Padua, Padua
Livio Simioni
Affiliation:
Service of Preventive Medicine for Healthcare Workers, Feltre
Guglielmo Amato
Affiliation:
Mirano, Italy
*
Department of Environmental Medicine and Public Health, University of Padova, via Giustiniani 2, Padova, 35128, Italy ([email protected])
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Abstract

Objective.

To determine whether self-reported history of disease and/or vaccination is predictive of immunity against hepatitis B, varicella, rubella, mumps, and measles.

Design.

The seroprevalence of viral antibodies and the predictive value of a self-report questionnaire were determined for 616 paramedical students who matriculated into Padua Medical School (Padua, Italy) during 2003-2005.

Results.

The majority of subjects (86.9%) remembered being vaccinated against hepatitis B but had no recollection of disease. Among vaccinees, 1.5% showed markers of previous infection, 6.7% tested negative for anti-hepatitis B virus surface antigen (anti-HBsAg) antibodies, and 91.8% tested positive for anti-HBsAg. Self-reported vaccination history had a positive predictive value of 93.2% for test results positive for immunity against hepatitis B. Immunity against varicella (93.7% of subjects) and rubella (95.5%) was high, compared with immunity against mumps (79.9%) and measles (83.1%). In addition, results of tests for detection of immunity against mumps and measles were equivocal for more than 7% of subjects, probably because their vaccination regimen was not completed. Self-reported histories of varicella disease and rubella disease and vaccination had high positive predictive values (greater than 98% each) for testing positive for antiviral antibodies, compared with self-reported histories of mumps disease and vaccination and measles disease and vaccination; however, high positive predictive values were observed for self-reported histories of mumps only (92.0%) and measles only (94.7%).

Conclusions.

The self-report questionnaire used in this study did not accurately predict immunity against 5 transmittable but vaccine-preventable diseases. A complete serological evaluation of healthcare workers, followed by vaccination of those with negative or equivocal results of serological tests, is an appropriate measure to decrease the risk of infection in this population.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 5 , May 2007 , pp. 564 - 569
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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