The impact of hepatitis B vaccination in a Western country: Recall of vaccination and serological status in Australian adults

Notifications of acute icteric hepatitis B have declined since the introduction of vaccination but it is not clear whether the reservoir of infection and the proportion of adults who remain susceptible have also changed. This has been investigated by evaluation of serological evidence of infection a...

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Bibliographic Details
Published in:Vaccine 2006-02, Vol.24 (8), p.1095-1106
Main Authors: Tawk, Hani M., Vickery, Karen, Bisset, Linda, Selby, Warwick, Cossart, Yvonne E.
Format: Article
Language:English
Subjects:
Adult
Aged
Applied microbiology
Australia
Biological and medical sciences
Confidence intervals
Female
Fundamental and applied biological sciences. Psychology
Health facilities
Hepatitis
Hepatitis A virus
Hepatitis B
Hepatitis B - prevention & control
Hepatitis B Antibodies - blood
Hepatitis B Vaccines - immunology
Hepatitis B virus
Hepatitis C virus
Hospitals
Human viral diseases
Humans
Immunity
Immunization
Infectious diseases
Male
Medical sciences
Microbiology
Middle Aged
Multivariate Analysis
Odds Ratio
Patients
Questionnaires
Risk factors
Sex Factors
Studies
Vaccination
Vaccines
Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects)
Viral diseases
Viral hepatitis
Workers
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Summary:Notifications of acute icteric hepatitis B have declined since the introduction of vaccination but it is not clear whether the reservoir of infection and the proportion of adults who remain susceptible have also changed. This has been investigated by evaluation of serological evidence of infection and immunity, patient recall of vaccination and risk factors for exposure to hepatitis B in 2115 adult endoscopy patients in central Sydney. Twenty-one percent were immune, two thirds of these by vaccination. One third of the 440 who recalled “vaccination” were anti-HBs negative. 2.1% of the cohort was HBsAg positive and of these 31% (14/45) were viraemic. Amongst epidemiological risk groups recommended for vaccination, multivariate analysis showed that health care workers (odd ratio, OR = 5.35) and patients diagnosed with hepatitis A (OR = 2.6) or hepatitis C (OR = 2.1) were 5.35, 2.6 and 2.1 times more likely to be immunised, respectively. The great majority of immigrants from high prevalence countries, and of patients reporting other known risks for hepatitis B exposure remain susceptible.
ISSN:0264-410X
1873-2518
DOI:10.1016/j.vaccine.2005.09.008