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Serologic Testing for Protection against Hepatitis B Virus Infection among Students at a Health Sciences University in the United States

  • Philip R. Spradling (a1), Roxanne E. Williams (a1) (a2), Jian Xing (a1), Kenneth Soyemi (a3) and Joseph Towers (a4)...

Abstract

Objective.

To evaluate hepatitis B vaccination coverage and documentation of vaccine-induced immunity.

Design.

Retrospective cohort analysis.

Setting.

Graduate school in the United States with programs in osteopathic medicine, dentistry, and allied health.

Methods.

Data collected included demographics, dates of hepatitis B vaccine doses, and postvaccination concentrations of antibody to hepatitis B surface antigen (anti-HBs), with dates. The proportions of students with anti-HBs of 10 IU/L or more by demographics, age at vaccination, interval since completion of the primary series, and response to additional vaccine doses were compared.

Results.

Of 3,452 students who matriculated during 2004–2009, 2,643 had complete data; 2,481 (93.9%) received 3 primary doses. Most were women (64.6%), US-born (85.6%), and white (63.2%); median age at receipt of the primary series was 14.5 years (interquartile range, 11.6–20.2 years) and at postvaccination testing was 23.2 years (interquartile range, 22.1–24.8 years). Of those who received 3 primary doses, 2,306 (92.9%) had an anti-HBs postvaccination concentration of 10 IU/L or more. Younger age at vaccination and longer time interval from vaccination to anti-HBs testing were associated with a postvaccination concentration of less than 10 IU/L (P < .001 and P = .0185, respectively, Cochran-Armitage test for trend). Almost all students (98.2%) who initially had less than 10 IU/L of anti-HBs, but then received at least 1 additional dose, had a follow-up anti-HBs concentration of 10 IU/L or more.

Conclusions.

Almost all students had serologic evidence of protection against hepatitis B virus infection; most were vaccinated as adolescents and were tested more than 10 years after vaccination. Among students with anti-HBs concentrations of less than 10 IU/L, nearly all had 10 IU/L or more after at least 1 additional vaccine dose.

Copyright

Corresponding author

Division of Viral Hepatitis, National Center for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Mailstop G37, 1600 Clifton Road NE, Atlanta, GA 30333 (pspradling@cdc.gov)

References

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1. CDC. Recommendation of the immunization practices advisory committee (ACIP) inactivated hepatitis B virus vaccine. MMWR 1982;31:317322, 327-328.
2. CDC. Immunization of health-care personnel: recommendations of the advisory committee on immunization practices (ACIP). MMWR 2011;60(RR07):145. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6007al.htm.
3. Leuridan, E, Van Damme, P. Hepatitis B and the need for a booster dose. Clin Infect Dis 2011;53:6875.
4. CDC. Achievements in public health: hepatitis B vaccination—United States, 1982-2002. MMWR 2002;51:549552, 563.
5. Lindley, MC, Lörick, SA, Spinner, JR, et al. Student vaccination requirements of US health professional schools: a survey. Ann Intern Med 2011;154:391400.
6. CDC. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States. Recommendations of the advisory committee on immunization practices (ACIP), part II: immunization of adults. MMWR 2006; 55(RR16):133.

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