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Quantification of Anti-HBs in vaccinated healthcare workers at a tertiary care center

Author: 
Kalyani Borde, Dr. Mythri, Dr. Jyoti S. Kabbin and Dr. Ambica, R.
Subject Area: 
Health Sciences
Abstract: 

Introduction: Hepatitis B is the most common blood borne infection after occupational exposure in India. Awareness towards adult vaccination against hepatitis B is slowly rising amongst healthcare workers. However, it is well demonstrated that vaccine does not offer protection in 100% of recipients. It is important to seek out the vaccine non-responders as the post exposure management depends on the immune status of the vaccine recipient. Objective: To check the immune response after hepatitis B vaccination and identify the non-responders. Method: Healthcare workers were immunized with recombinant hepatitis B vaccine (GeneVac) according to the revised rapid schedule of 0-1-2. Antibody titers were checked after 6 weeks in HCWs who completed 3 doses of immunization. Blood samples for testing were collected and serum separated by centrifugation. Serum was stored at 4°C for no longer than 4 days. Anti-HBS quantitative ELISA (MBS, Italy) was used to measure the antibody titers. Serum samples from HCWs showing titers <10mIU/ml were retested after repeat vaccination. Result: A total of 203 HCWs were tested for post-vaccination antibody titers. Of these, 39 samples showed titers below 10mIU/ml (19%). 15 out of 39 had undetectable levels. Repeat testing was done after administration of repeat vaccination in 20 HCWs – 14 of them seroconverted. Conclusion: This study concludes that vaccination is not protective in 100% of recipients. As the HCWs are at an increased risk of exposure, it is advisable to check the immunity against hepatitis B, after finishing complete schedule of vaccination. In this way, non-responders can be identified to be revaccinated or relieved from high-risk areas.

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