Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-30T21:37:26.201Z Has data issue: false hasContentIssue false

Barriers to Hepatitis B Vaccine Coverage among Healthcare Workers in the Republic of Georgia: An International Perspective

Published online by Cambridge University Press:  02 January 2015

M. Topuridze*
Affiliation:
Maternal and Child Care Union, Tbilisi, Georgia
M. Butsashvili
Affiliation:
Maternal and Child Care Union, Tbilisi, Georgia
G. Kamkamidze
Affiliation:
Maternal and Child Care Union, Tbilisi, Georgia
M. Kajaia
Affiliation:
Maternal and Child Care Union, Tbilisi, Georgia
D. Morse
Affiliation:
New York State Department of Health, Albany, New York School of Public Health, University at Albany, Albany, New York
L. A. McNutt
Affiliation:
School of Public Health, University at Albany, Albany, New York
*
Maternal and Child Care Union, 10a Bakhtrioni Street, Tbilisi, Georgia([email protected])

Extract

Background.

While the Republic of Georgia has a high prevalence of hepatitis B virus (HBV) infection (3.4% of blood donors tested positive for HBV surface antigen [HBsAg]), relatively few healthcare workers (HCWs) are thought to be immunized.

Objective.

To measure rates of HBV vaccination coverage and identify predictors of vaccine acceptance among HCWs.

Design.

Cross-sectional survey.

Methods.

A study was conducted among full-time physicians and nurses at 2 large hospitals. Self-administered questionnaires included questions about demographic characteristics, HBV vaccine status, willingness to recommend vaccination to other HCWs, and barriers to vaccination. Laboratory tests were conducted for identification of HBsAg and antibody to hepatitis B core antigen.

Results.

A total of 297 (91%) of 325 randomly selected HCWs provided information for the study (124 physicians and 173 nurses). The rate of HBV vaccination coverage was 12%, and 54% of respondents indicated that they would recommend vaccination to other HCWs. Perception of vaccine safety was identified as the most important predictor for acceptance (prevalence ratio [PR] 3.3 [95% confidence ratio {CI}, 1.2-8.9]) and for willingness to recommend HBV vaccination to other HCWs (PR, 5.5 [95% CI, 3.1-9.4]). Vaccinated HCWs were more likely to recommend vaccination to other healthcare personnel (PR, 1.7 [95% CI, 1.5-2.1]), as were those younger than 40 years of age (PR, 6.0 [95% CI, 2.8-12.6]). Multivariate analyses identified 2 additional factors associated with vaccine acceptance and willingness to recommend vaccination: the hospital at which the HCW was employed and the perception of risk of infection for HCWs.

Conclusion.

Georgia plans a major HBV vaccination campaign for HCWs in 2009. The campaign's success will depend on addressing vaccine safety concerns identified in this study and educating HCWs about risk factors for infection and benefits of immunization.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Szmuness, W, Prince, AM, Grady, GF, et al.Hepatitis B infection: a point-prevalence study in 15 US hemodialysis centers. JAMA 1974;227:901906.Google Scholar
2.Geretty, RJ. Hepatitis B transmission between dental or medical workers and patients. Ann Intern Med 1981;95:229231.Google Scholar
3.Seyckova, J, Hele, J. Prevalence of viral hepatitis among the hospital staff in CSR between 1980 and 1982. J Hyg Epidemiol Microbiol Immunol 1984;28:267278.Google Scholar
4.World Health Organization Regional Office for Europe. European health for all database (HFA-DB). Available at: http://data.euro.who.int/hfadb/. Accessed April 29, 2007.Google Scholar
5.Butsashvili, M, Tsertsvadze, T, McNutt, LA, et al.Prevalence of hepatitis B, hepatitis C, syphilis and HIV in Georgian blood donors. Eur J Epidemiol 2001;17(7):693695.Google Scholar
6.McNutt, LA, Wu, C, Xue, X, Hafner, JP. Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am J Epidemiol 2003;157(10):940943.Google Scholar
7.Braka, F, Nanyunja, M, Makumbi, I, et al.Hepatitis B infection among health workers in Uganda: evidence of the need for health worker protection. Vaccine 2006;24:69306937.Google Scholar
8.Suckling, RM, Taegtmeyer, M, Nguku, PM, et al.Susceptibility of healthcare workers in Kenya to hepatitis B: new strategies for facilitating vaccination uptake. J Hosp Infect 2006;64(3):271277.CrossRefGoogle ScholarPubMed
9.Talaat, M, Kandeel, A, El-Shoubary, W, et al.Occupational exposure to needlestick injuries and hepatitis B vaccination coverage among health care workers in Egypt. Am J Infect Control 2003;31(8):469474.Google Scholar
10.Simard, EP, Miller, JT, George, PA, et al.Hepatitis B vaccination coverage levels among healthcare workers in the United States, 2002-2003. Infect Control Hosp Epidemiol 2007;28(7):783790.Google Scholar
11.Batista, S, Andreas, M, Borges, A, et al.Seropositivity for hepatitis B virus, vaccination coverage, and vaccine response in dentists from Campo Grande, Mato Grosso do Sul, Brazil. Mem Inst Oswaldo Cruz 2006;101(3): 263267.Google Scholar
12.Dannetun, E, Tegnell, A, Torner, A, et al.Coverage of hepatitis B vaccination in Swedish healthcare workers. J Hosp Infect 2006;63(2):201204.Google Scholar
13.Vranckx, R, Jacque, P, De Schrijver, A, et al.Hepatitis B vaccination coverage in Belgian health care workers. Infection 2004;32(5):278281.Google Scholar
14.National Center of Disease Control and Public Health. Epidemiological Bulletin. 2005;1:110. Available at: http://www.ncdc.ge/GEO/Publications/Bulletin/bulletin_2005/Bul_l.pdf. Accessed April 29, 2007.Google Scholar
15.Centers for Disease Control and Prevention. Hepatitis B. The Pink Book: Epidemiology and Prevention of Vaccine-Preventable Diseases. Atlanta, GA: CDC; 2005:191212.Google Scholar
16.Woo, EJ, Miller, NB, Ball, R; VAERS Working Group. Adverse events after hepatitis A, B combination vaccine. Vacane 2006;24(14):26852691.Google Scholar
17.Jain, A, Mathur, US, Jandwani, P, et al.A multicentric evaluation of recombinant DNA hepatitis B vaccine of Cuban origin. Trop Gastroenterol 2000;21(1):1417.Google Scholar
18.Madsen, KM, Hviid, A, Vestergaard, M, et al.A population-based study of measles, mumps, and rubella vaccination and autism. N Engl J Med 2002;347:14771482.Google Scholar
19.Hviid, A, Stellfeld, M, Wohlfahrt, J, et al.Childhood vaccination and type 1 diabetes. N Engl J Med 2004;350:13981404.Google Scholar
20.Confavreux, C, Suissa, S, Saddier, P, et al.Vaccinations and the risk of relapse in multiple sclerosis. Vaccines In Multiple Sclerosis Study Group. N Engl J Med 2001;344:319326.Google Scholar
21.Anderson, HR, Poloniecki, JD, Strachan, DP, et al.Immunization and symptoms of atopic disease in children: results from the International Study of Asthma and Allergies in Childhood. Am J Public Health 2001;9:11261129.Google Scholar
22.Vaccine Safety Datalink (VSD) Project. Annual report, 2004-2005. Washington, DC: America's Health Isurance Plans, 2005. Available at: http://www.ahip.org/content/fileviewer.aspx?docid = 307&1inkid = 150678. Accessed April 20, 2007.Google Scholar
23.Vaccine Adverse Event Reporting System (VAERS). Rockville, MD: CDC. Available at: http://vaers.hhs.gov/resources/index. Accessed April 29, 2007.Google Scholar
24.Geier, MR, Geier, DA, Zahalsky, AC. A review of hepatitis B vaccination. Expert Opin Drug Saf 2003;2(2):113122.Google Scholar
25.World Health Organization. Hepatitis B vaccines. Wkly Epidemiol Rec 2004;79:255263.Google Scholar
26.World Health Organization. Global Advisory Committee on Vaccine Safety, 12-13 December 2007. Wkly Epidemiol Rec 2008;83:3744.Google Scholar
27.McMahon, BJ, Helminiak, C, Wainwright, RB, Bulkow, L, Trimble, BA, Wainwright, K. Frequency of adverse reactions to hepatitis B vaccine in 43,618 persons. Am J Med 1992;92:254256.Google Scholar
28.Niu, MT, Salive, ME, Ellenberg, SS. Neonatal deaths after hepatitis B vaccine: the Vaccine Adverse Event Reporting System, 1991-1998. Arch Pediatr Adolesc Med 1999;153:12791282.Google Scholar
29.Lewis, E, Shinefield, HR, Woodruff, BA, et al.Safety of neonatal hepatitis B vaccine administration. Pediatr Infect Dis J 2001;20:10491054.Google Scholar
30.Zanetti, AR. Update on hepatitis B vaccination in Italy 10 years after its implementation. Vaccine 2001;19:23802383.Google Scholar
31.Yu, AS, Cheung, RC, Keeffe, EB. Hepatitis B vaccines. Clin Liver Dis 2004;8:283300.Google Scholar
32.Lemon, SM, Thomas, DL. Vaccines to prevent viral hepatitis. N Engl J Med 1997;336:196204.CrossRefGoogle ScholarPubMed
33.Shaw, FE Jr, Graham, DJ, Guess, HA, et al.Postmarketing surveillance for neurologic adverse events reported after hepatitis B vaccination: experience of the first three years. Am J Epidemiol 1988;127:337352.Google Scholar
34.Gulua, N. Case report: encephalomyelitis caused by hepatitis B vaccination. Spirit Lake, Idaho: Vaccination Liberation. Available at: http://www.vaclib.org/basic/Case_Report.doc. Accessed April 29, 2007.Google Scholar
35.Centers for Disease Control and Prevention. Hepatitis B fact sheet. Atlanta, GA: CDC; 2006. Available at: http://www.cdc.gov/hepatitis/Resources/Professionals/PDFs/ABCTable_BW.pdf. Accessed April 29, 2007.Google Scholar
36.Centers for Disease Control and Prevention. Vaccine information statement. Atlanta, GA: CDC; 2007. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-hep-b.pdf. Accessed April 29, 2007.Google Scholar
37.Azap, A, Ergönül, O, Memikoğlu, KO, et al.Occupational exposure to blood and body fluids among health care workers in Ankara, Turkey. Am J Infect Control 2005;33(1):4852.Google Scholar
38.Erdem, Y, Talas, MS. Blunt and penetrating object injuries in housekeepers working in a Turkish university hospital. Am J Infect Control 2006;34(4): 208214.Google Scholar