title: Barriers to hepatitis B vaccine coverage among healthcare workers in the Republic of Georgia: An international perspective.
abstract: BACKGROUND
  While the Republic of Georgia has a high prevalence of hepatitis B virus (HBV) infection (3.4% of blood donors tested positive for HBV surface antigen [HBsAg]), relatively few healthcare workers (HCWs) are thought to be immunized.
  
  
  OBJECTIVE
  To measure rates of HBV vaccination coverage and identify predictors of vaccine acceptance among HCWs.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  A study was conducted among full-time physicians and nurses at 2 large hospitals. Self-administered questionnaires included questions about demographic characteristics, HBV vaccine status, willingness to recommend vaccination to other HCWs, and barriers to vaccination. Laboratory tests were conducted for identification of HBsAg and antibody to hepatitis B core antigen.
  
  
  RESULTS
  A total of 297 (91%) of 325 randomly selected HCWs provided information for the study (124 physicians and 173 nurses). The rate of HBV vaccination coverage was 12%, and 54% of respondents indicated that they would recommend vaccination to other HCWs. Perception of vaccine safety was identified as the most important predictor for acceptance (prevalence ratio [PR], 3.3 [95% confidence ratio {CI}, 1.2-8.9]) and for willingness to recommend HBV vaccination to other HCWs (PR, 5.5 [95% CI, 3.1-9.4]). Vaccinated HCWs were more likely to recommend vaccination to other healthcare personnel (PR, 1.7 [95% CI, 1.5-2.1]), as were those younger than 40 years of age (PR, 6.0 [95% CI, 2.8-12.6]). Multivariate analyses identified 2 additional factors associated with vaccine acceptance and willingness to recommend vaccination: the hospital at which the HCW was employed and the perception of risk of infection for HCWs.
  
  
  CONCLUSIONS
  Georgia plans a major HBV vaccination campaign for HCWs in 2009. The campaign's success will depend on addressing vaccine safety concerns identified in this study and educating HCWs about risk factors for infection and benefits of immunization.
authors.affiliation: From the Maternal and Child Care Union, Tbilisi, Georgia. marina_topuridze@yahoo.com
authors.forename: M
authors.initials: M
authors.lastname: Topuridze
authors.forename: M
authors.initials: M
authors.lastname: Butsashvili
authors.forename: G
authors.initials: G
authors.lastname: Kamkamidze
authors.forename: M
authors.initials: M
authors.lastname: Kajaia
authors.forename: D
authors.initials: D
authors.lastname: Morse
authors.forename: L A
authors.initials: LA
authors.lastname: McNutt
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D005846:Georgia (Republic); D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000706:statistics & numerical data*; D006509:Hepatitis B / Q000453:epidemiology / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000009:adverse effects; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D017325:Hepatitis B Vaccines