title: Risk factors for lack of detectable antibody following hepatitis B vaccination of Minnesota health care workers.
abstract: OBJECTIVE
  To assess the presence of antibody to hepatitis B surface antigen (anti-HBs) at postvaccination testing in Minnesota health care workers receiving recombinant hepatitis B vaccines, and to identify risk factors for lacking anti-HBs following hepatitis B vaccination.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Ten acute care hospitals in Minnesota.
  
  
  METHODS
  A total of 595 health care workers who had received hepatitis B vaccine (Recombivax HB or Engerix-B) between June 1987 and December 1991 and who underwent postvaccination testing for anti-HBs within 6 months after receiving the third dose of vaccine.
  
  
  METHODS
  Presence or absence of anti-HBs following hepatitis B vaccination.
  
  
  RESULTS
  Five variables were independently associated with lacking anti-HBs by multivariate analysis: vaccine brand, smoking status, gender, age, and body mass index. Stratifying by vaccine brand demonstrated that age (P = .01), body mass index (P < .01), and smoking status (P < .01) were associated with lacking anti-HBs only for Recombivax HB recipients; and gender (P = .03) was associated with lacking anti-HBs only for Engerix-B recipients. After controlling for smoking status, age, gender, and body mass index, recipients of Recombivax HB were more likely to lack anti-HBs than recipients of Engerix-B (relative risk, 2.3; 95% confidence interval, 1.1 to 4.7; P = .02).
  
  
  CONCLUSIONS
  Results indicate that certain populations of health care workers are at increased risk of not responding to hepatitis B vaccination. Further studies evaluating immunogenicity of currently available recombinant hepatitis B vaccines in persons at high risk for primary vaccine failure are needed.
authors.affiliation: Acute Disease Epidemiology Section, Minnesota Department of Health, Minneapolis 55440-9441.
authors.forename: R C
authors.initials: RC
authors.lastname: Wood
authors.forename: K L
authors.initials: KL
authors.lastname: MacDonald
authors.forename: K E
authors.initials: KE
authors.lastname: White
authors.forename: C W
authors.initials: CW
authors.lastname: Hedberg
authors.forename: M
authors.initials: M
authors.lastname: Hanson
authors.forename: M T
authors.initials: MT
authors.lastname: Osterholm
mesh_terms: D000328:Adult; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000096:biosynthesis*; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D015999:Multivariate Analysis; D016272:Occupational Health / Q000706:statistics & numerical data; D010564:Personnel, Hospital / Q000706:statistics & numerical data; D012307:Risk Factors; D017211:Treatment Failure; D014614:Vaccines, Synthetic / Q000276:immunology*
chemical_list: C075654:Engerix-B; D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; C075655:Recombivax HB; D014614:Vaccines, Synthetic