Roush S W, Hadler S C, Shapiro C N, Schatz G C
Division of Viral and Rickettsial Diseases, Centers for Disease Control, Atlanta, GA 30333.
Public Health Rep. 1991 Sep-Oct;106(5):529-35.
Hepatitis B is a well-documented occupational hazard for health care workers, including both laboratory and nursing personnel. Since the development of effective hepatitis B vaccines, the Immunization Practices Advisory Committee (ACIP) has recommended that health care workers receive the vaccine. In this study, 78 laboratory training programs and 83 nursing training programs were surveyed regarding availability and usage of hepatitis B vaccine. The hepatitis B vaccine was made available to students in 81 percent of the laboratory programs and 23 percent of the nursing programs. In those programs making the vaccine available, only 59 percent of the laboratory programs and 5 percent of the nursing programs reported a high (greater than 75 percent) use by students. Concern about cost and payment for the vaccine was the most common reason (80 percent) noted by laboratory schools that did not have hepatitis B vaccination programs for students. Of the nursing schools that did not have vaccine programs, 58 percent had not yet considered a program. At laboratory schools with vaccination programs, who paid for the vaccine (hospital or school versus student) was among the most important determinants for vaccine usage by students. These findings point out that some laboratory schools and many nursing schools have not applied the ACIP recommendations to their own programs. Educational efforts and creative payment plans for the vaccine are needed to increase the availability and use of hepatitis B vaccine among laboratory and nursing students.
乙型肝炎是医护人员(包括实验室人员和护理人员)中记录充分的职业危害。自从有效的乙型肝炎疫苗研制出来后,免疫实践咨询委员会(ACIP)就建议医护人员接种该疫苗。在这项研究中,针对78个实验室培训项目和83个护理培训项目,就乙型肝炎疫苗的供应情况和使用情况进行了调查。在81%的实验室培训项目和23%的护理培训项目中,向学生提供了乙型肝炎疫苗。在那些提供疫苗的项目中,只有59%的实验室培训项目和5%的护理培训项目报告称学生的使用率较高(超过75%)。对于没有为学生开展乙型肝炎疫苗接种项目的实验室学校而言,对疫苗成本和支付问题的担忧是最常见的原因(80%)。在没有疫苗项目的护理学校中,58%尚未考虑开展此类项目。在设有疫苗接种项目的实验室学校中,由谁支付疫苗费用(医院、学校还是学生)是学生疫苗使用情况的最重要决定因素之一。这些研究结果表明,一些实验室学校和许多护理学校并未将ACIP的建议应用于自身项目。需要开展教育工作并制定创新的疫苗支付计划,以提高实验室和护理专业学生对乙型肝炎疫苗的可及性和使用率。