title: Vaccination against hepatitis b virus: are Italian medical students sufficiently protected after the public vaccination programme?
abstract: BACKGROUND
  The development of a vaccine against hepatitis B virus (HBV) has been a major achievement in terms of prevention of HBV infection. For the present study, we analysed the long-term immunogenicity and effectiveness of HBV vaccination among healthcare students with different working seniorities.
  
  
  METHODS
  A cross-sectional study of undergraduate and postgraduate students attending the Medical School of the Second University of Naples was conducted between September 2012 and December 2014. HBV serum markers were determined and multivariate logistic regression analysis was used to identify factors associated with the level of long-term immunogenicity.
  
  
  RESULTS
  Of the 2,932 subjects evaluated, only 33 (1.1 %) declared no history of vaccination. All vaccinated subjects were HBsAg/anti-HBc negative, 459 of which had an anti-HBs titre <10 IU/L. The latter were younger, more likely to be attending a healthcare profession school (i.e., dental hygienists, nursing, paediatric nursing, radiography and midwifery) than a medical school (at either undergraduate or postgraduate level) and more likely to have been vaccinated in infancy.
  
  
  CONCLUSIONS
  The results of this study suggest that assessment of HBV serum markers in workers potentially exposed to hospital infections is useful to identify small numbers of unvaccinated subjects or vaccinated subjects with low antibody titre, all of whom should be referred to a booster series of vaccinations.
authors.affiliation: Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Lamberti
authors.affiliation: Department of Orthodontics, Second University of Naples, Naples, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: De Rosa
authors.affiliation: Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy.
authors.forename: Elpidio Maria
authors.initials: EM
authors.lastname: Garzillo
authors.affiliation: Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy.
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Corvino
authors.affiliation: Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Sannolo
authors.affiliation: Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Naples, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: De Pascalis
authors.affiliation: Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy.
authors.forename: Eliana
authors.initials: E
authors.lastname: Di Fiore
authors.affiliation: Institute for Health Services, Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Westermann
authors.affiliation: Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Arnese
authors.affiliation: Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, Naples, 80133 Italy.
authors.forename: Di Giuseppe
authors.initials: DG
authors.lastname: Gabriella
authors.affiliation: Institute for Health Services, Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.|Institution for Statutory Accident Insurance and Prevention in Healthcare and Welfare Services, Hamburg, Germany.
authors.forename: Albert
authors.initials: A
authors.lastname: Nienhaus
authors.affiliation: Department of Operative Dentistry, Dental School, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, MG Brazil.
authors.forename: Antônio Paulino Ribeiro
authors.initials: APR
authors.lastname: Sobrinho
authors.affiliation: Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Coppola
keywords: Anti-HBs titre; HBV infection; HBV vaccination; Healthcare students