Hepatitis B vaccination coverage levels among healthcare workers in the United States, 2002-2003.
BACKGROUND
Hepatitis B virus (HBV) infection is a well recognized risk for healthcare workers (HCWs), and routine vaccination of HCWs has been recommended since 1982. By 1995, the level of vaccination coverage among HCWs was only 67%.


OBJECTIVE
To obtain an accurate estimate of hepatitis B vaccination coverage levels among HCWs and to describe the hospital characteristics and hepatitis B vaccination policies associated with various coverage levels.


METHODS
Cross-sectional survey.


METHODS
A representative sample of 425 of 6,116 American Hospital Association member hospitals was selected to participate, using probability-proportional-to-size methods during 2002-2003. The data collected included information regarding each hospital's hepatitis B vaccination policies. Vaccination coverage levels were estimated from a systematic sample of 25 HCWs from each hospital whose medical records were reviewed for demographic and vaccination data. The main outcome measure was hepatitis B vaccination coverage levels.


RESULTS
Among at-risk HCWs, 75% had received 3 or more doses of the hepatitis B vaccine, corresponding to an estimated 2.5 million vaccinated hospital-based HCWs. The coverage level was 81% among staff physicians and nurses. Compared with nurses, coverage was significantly lower among phlebotomists (71.1%) and nurses' aides and/or other patient care staff (70.9%; P<.05). Hepatitis B vaccination coverage was highest among white HCWs (79.5%) and lowest among black HCWs (67.6%; P<.05). Compared with HCWs who worked in hospitals that required vaccination only of HCWs with identified risk for exposure to blood or other potentially infectious material, hepatitis B vaccination coverage was significantly lower among HCWs who worked in hospitals that required vaccination of HCWs without identified risk for exposure to blood or other potentially infectious material (76.6% vs 62.4%; P<.05).


CONCLUSIONS
In the United States, an estimated 75% of HCWs have been vaccinated against hepatitis B. Important differences in coverage levels exist among various demographic groups. Hospitals need to identify methods to improve hepatitis B vaccination coverage levels and should consider developing targeted vaccination programs directed at unvaccinated, at-risk HCWs who have frequent or potential exposure to blood or other potentially infectious material.
Simard
Edgar P
EP
Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. esimard@alum.emory.edu
Miller
Jeremy T
JT
George
Prethibha A
PA
Wasley
Annemarie
A
Alter
Miriam J
MJ
Bell
Beth P
BP
Finelli
Lyn
L
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D016602:Needlestick Injuries; D016273:Occupational Exposure; D010564:Personnel, Hospital / Q000706:statistics & numerical data*; D014481:United States
D017325:Hepatitis B Vaccines