Hepatitis B Vaccination for Healthcare Students Lags Behind Recommendations

July 26, 2011

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A study in the August issue of Infection Control and Hospital Epidemiology, the

journal of the Society for Healthcare Epidemiology of America (SHEA), suggests

that documentation of hepatitis B vaccination for healthcare students may fall

short of current recommendations.

Researchers led by Dr. Rania Tohme of the Centers for Disease Control and

Prevention (CDC) analyzed hepatitis B immunization records of 4,075 healthcare

students who matriculated at a university in the southeastern U.S. between

January 2000 and January 2010. The study found that only 59.8 percent of

students had documentation of complete vaccination against hepatitis B, and that

only 83.8 percent were protected against hepatitis B infection when tested for

the presence of hepatitis B antibodies. These rates are lower than the U.S.

government's Healthy People 2010 goal of 90 percent hepatitis B vaccination

coverage among health care workers.

The study also found that very few students had been vaccinated during childhood

according to the CDC and the Advisory Committee for Immunization Practices

(ACIP) recommendations in effect at the time. In 1995, CDC and ACIP recommended

routine vaccination of previously unvaccinated children aged 11-12 years, and

vaccination for all children 18 and under in 1999. However, the majority of

students with documented vaccination were only recently vaccinated, either

during or a few years prior to matriculation.

CDC and ACIP currently recommend vaccinating all infants at birth, as well as

all adolescents and at-risk adults who have not yet received the vaccine.

Additionally, all health care workers who may be exposed to blood or

blood-contaminated products should be both vaccinated for hepatitis B and tested

for antibodies to ensure protection against infection.

Although health care students are exposed during their training to bloodborne

pathogens, including hepatitis B, little or no information was available

regarding hepatitis B vaccination coverage at matriculation among this group in

the United States prior to the publication of this study, the researchers say.

Health care students are at risk of exposure to hepatitis B virus during their

training and later during their career. Previous studies have documented

frequent needle stick injuries among medical students, with 8 percent of

occurrences involving a known hepatitis B carrier. Therefore, vaccination and

documentation of protection would help decrease risk of infection.

The researchers caution that these results are limited to one university, and

may not be generalizable to other institutions.

Reference: Rania A. Tohme, Bruce Ribner, J. Huey, Philip R. Spradling.

Hepatitis B Vaccination Coverage and Documented Seroprotection among

Matriculating Health Care Students at an Academic Institution in the United

States. Infection Control and Hospital Epidemiology 32:8 (August 2011).

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July 26, 2011