title: Hepatitis B vaccination of susceptible elderly residents of long term care facilities during a hepatitis B outbreak.
abstract: Protection of older persons, particularly those with diabetes, against hepatitis B virus (HBV) infection is of growing concern because of increased reports of outbreaks among long-term care facility residents receiving assisted blood glucose monitoring. We evaluated hepatitis B vaccine immunogenicity among residents immunized in response to two such outbreaks in skilled nursing facilities during June 2009-July 2010. One hundred forty-eight (71%) of 209 residents were found to be susceptible to HBV infection. Of 105 patients who began a vaccination series with Twinrix(®) (0-, 1-, 6-month dosing), 86 (82%) completed the series and postvaccination testing. Of these, most were elderly (median age 79.5 years; range 45-101), female (56%), and African-American (51%). Twenty-nine (34%) vaccinated residents had post-vaccination hepatitis B surface antibody levels ≥10 mIU/ml. There were no significant differences in vaccine response by age, gender, race, diabetes status, body mass index, or current smoking status. Our findings indicate that a low proportion of skilled nursing facility residents achieved a seroprotective response after hepatitis B vaccination.
authors.affiliation: Division of Viral Hepatitis, Centers for Disease Control, Prevention, Atlanta, GA, United States.
authors.forename: Roxanne E
authors.initials: RE
authors.lastname: Williams
authors.forename: Arlene C
authors.initials: AC
authors.lastname: Sena
authors.forename: Anne C
authors.initials: AC
authors.lastname: Moorman
authors.forename: Zack S
authors.initials: ZS
authors.lastname: Moore
authors.forename: Umid M
authors.initials: UM
authors.lastname: Sharapov
authors.forename: Jan
authors.initials: J
authors.lastname: Drobenuic
authors.forename: Dale J
authors.initials: DJ
authors.lastname: Hu
authors.forename: Hattie W
authors.initials: HW
authors.lastname: Wood
authors.forename: Jian
authors.initials: J
authors.lastname: Xing
authors.forename: Philip R
authors.initials: PR
authors.lastname: Spradling
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control*; D004196:Disease Outbreaks; D005260:Female; D006268:Health Facilities; D022362:Hepatitis A Vaccines / Q000008:administration & dosage / Q000276:immunology*; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000276:immunology*; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D017778:Vaccines, Combined / Q000008:administration & dosage / Q000276:immunology
chemical_list: D022362:Hepatitis A Vaccines; D017325:Hepatitis B Vaccines; D017778:Vaccines, Combined; C433226:twinrix