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Persistence of Antibody in Healthcare Workers Vaccinated Against Hepatitis B

Published online by Cambridge University Press:  21 June 2016

Alan C. Street ,
Teresa Z. Weddle ,
Wayne R. Thomann ,
Ellen W. Lundberg ,
George W. Jackson  and
John D. Hamilton
Alan C. Street
Affiliation:
Department of Medicine, Durham VA Medical Center, Duke University Medical Center, Durham, North Carolina Department of Medicine, Duke University Medical Center, Durham, North Carolina
Teresa Z. Weddle
Affiliation:
Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina
Wayne R. Thomann
Affiliation:
Department of Environmental Safety, Duke University Medical Center, Durham, North Carolina
Ellen W. Lundberg
Affiliation:
Department of Radiology, Duke University Medical Center, Durham, North Carolina
George W. Jackson
Affiliation:
Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina
John D. Hamilton*
Affiliation:
Department of Medicine, Durham VA Medical Center, Duke University Medical Center, Durham, North Carolina Department of Medicine, Duke University Medical Center, Durham, North Carolina
*
Infectious Diseases, Department of Veterans' Affairs Medical Center, 508 Fulton Street, Durham, NC 27705
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Abstract

A cross-sectional serological survey was undertaken in 82 randomly selected high-risk healthcare workers previously vaccinated with the hepatitis B vaccine. The study design allowed for the identification and testing for hepatitis B surface antibody in equal numbers of employees in six-month intervals up to five years after vaccination. The results showed a consistent decline in antibody level with time, and an increasing proportion of participants with antibody levels below the commonly accepted protective level of ≥10 S/N (sample counts/negative control counts) radioimmunoassay units. The percent of vaccinees whose S/N ratio was greater than 10 fell from 10% at one year, to 25% at two years, to over 50% at four years. Based on these figures, as well as the financial costs of hepatitis B in employees and the predictability of booster immunization, it was possible to assess the cost benefit of a hospital policy for reimmunization. At our institution, a strategy of revaccination at fixed intervals could save up to $200,000 over a ten-year period if revaccination was not offered and vaccine efficacy declined. The information obtained should help determine the need for revaccination and the advantages and disadvantages of alternative revaccination strategies.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 11 , Issue 10 , October 1990 , pp. 525 - 530
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1990 

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