title: Natural and induced immunity to hepatitis B virus among the staff of a pediatric oncology center.
abstract: All employees of St. Jude Children's Research Hospital who were at risk for occupational exposure to hepatitis B virus were considered appropriate candidates for immunization when the vaccine was licensed in November 1981. Because a high prevalence of hepatitis B immunity was expected among the staff, preimmunization screening was undertaken in the belief that it would be cost effective. Of 315 candidates screened for antibody to the hepatitis B surface antigen (anti-HBs), 79 (25%) had detectable levels and 48 (15%) had titers of greater than or equal to 10 ratio units (RU). The highest rates of anti-HBs positivity were found among housekeepers (40%), nursing assistants (35%), physicians (31%), clinical laboratory workers (29%), and ward clerks (27%); nurses had the lowest rate (16%). An evaluation of potential risk factors implicated age greater than 30 years as having greatest importance. Serum samples were collected from 221 employees 3 months after their third dose of vaccine and tested for anti-HBs; 218 (98.6%) were seropositive. Eighteen employees who had detectable anti-HBs in the range of 2.1 to 9.9 RU before immunization responded well to the vaccine; the titers rose from an average of 4 RU before vaccination to an average of 313 RU 3 months after the third dose. The findings indicate that preimmunization screening of all health care workers identified as candidates for vaccination may not be necessary or economically feasible. If a screening program is undertaken, however, anti-HBs testing of only those persons greater than 30 years of age would increase the program's cost effectiveness.
mesh_terms: D000328:Adult; D000367:Age Factors; D002173:Cancer Care Facilities; D005260:Female; D006509:Hepatitis B / Q000276:immunology*; D006510:Hepatitis B Antibodies / Q000032:analysis*; D017325:Hepatitis B Vaccines; D006743:Hospital Bed Capacity, under 100; D006776:Hospitals, Pediatric; D006782:Hospitals, Special; D006801:Humans; D007113:Immunity, Innate; D008297:Male; D010564:Personnel, Hospital; D011863:Radioimmunoassay; D013714:Tennessee; D014611:Vaccination; D014761:Viral Hepatitis Vaccines / Q000276:immunology
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D014761:Viral Hepatitis Vaccines