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Hepatitis B Vaccination Coverage Levels Among Healthcare Workers in the United States, 2002-2003

Published online by Cambridge University Press:  02 January 2015

Edgar P. Simard*
Affiliation:
Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia University of Medicine and Dentistry of New Jersey, School of Public Health, Piscataway, New Jersey
Jeremy T. Miller
Affiliation:
General Dynamics Information Technology, Atlanta, Georgia
Prethibha A. George
Affiliation:
Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia University of Medicine and Dentistry of New Jersey, School of Public Health, Piscataway, New Jersey
Annemarie Wasley
Affiliation:
Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Miriam J. Alter
Affiliation:
Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia University of Texas Medical Branch at Galveston, Galveston, Texas
Beth P. Bell
Affiliation:
Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Lyn Finelli
Affiliation:
Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
*
317 George Street, Suite 210, New Brunswick, New Jersey 08901 (esimard@alum.emory.edu)

Abstract

Background.

Hepatitis B virus (HBV) infection is a well recognized risk for healthcare workers (HCWs), and routine vaccination of HCWs has been recommended since 1982. By 1995, the level of vaccination coverage among HCWs was only 67%.

Objective.

To obtain an accurate estimate of hepatitis B vaccination coverage levels among HCWs and to describe the hospital characteristics and hepatitis B vaccination policies associated with various coverage levels.

Design.

Cross-sectional survey.

Methods.

A representative sample of 425 of 6,116 American Hospital Association member hospitals was selected to participate, using probability-proportional-to-size methods during 2002-2003. The data collected included information regarding each hospital's hepatitis B vaccination policies. Vaccination coverage levels were estimated from a systematic sample of 25 HCWs from each hospital whose medical records were reviewed for demographic and vaccination data. The main outcome measure was hepatitis B vaccination coverage levels.

Results.

Among at-risk HCWs, 75% had received 3 or more doses of the hepatitis B vaccine, corresponding to an estimated 2.5 million vaccinated hospital-based HCWs. The coverage level was 81% among staff physicians and nurses. Compared with nurses, coverage was significantly lower among phlebotomists (71.1%) and nurses' aides and/or other patient care staff (70.9%; P < .05). Hepatitis B vaccination coverage was highest among white HCWs (79.5%) and lowest among black HCWs (67.6%; P < .05). Compared with HCWs who worked in hospitals that required vaccination only of HCWs with identified risk for exposure to blood or other potentially infectious material, hepatitis B vaccination coverage was significantly lower among HCWs who worked in hospitals that required vaccination of HCWs without identified risk for exposure to blood or other potentially infectious material (76.6% vs 62.4%; P < .05).

Conclusions.

In the United States, an estimated 75% of HCWs have been vaccinated against hepatitis B. Important differences in coverage levels exist among various demographic groups. Hospitals need to identify methods to improve hepatitis B vaccination coverage levels and should consider developing targeted vaccination programs directed at unvaccinated, at-risk HCWs who have frequent or potential exposure to blood or other potentially infectious material.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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