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甲型肝炎疫苗接种在医护人员中。

Hepatitis A vaccination in healthcare personnel.

机构信息

Division of Gastroenterology, Department of Medicine, University of Texas Medical Branch, Galveston, 77555, USA.

出版信息

Ann Hepatol. 2012 May-Jun;11(3):326-9.

Abstract

BACKGROUND AND AIMS

Despite effective vaccine available, hepatitis A remains a significant cause of morbidity and mortality worldwide including acute liver failure, transplantation and death. Vaccination rates for hepatitis A in the general population are low. Rates of hepatitis A vaccination in healthcare personnel (HCP) are unknown. We studied vaccination rate to hepatitis A in a cohort of HCP at a large US academic center.

MATERIAL AND METHODS

An anonymous survey was circulated between 499 HCP at-risk of hepatitis A exposure at our Institution. Results were corrected for non-response rate and compared with the general US population using the 2007 CDC-National Immunization Survey. Rate of hepatitis A vaccination was compared with Institutional rate of vaccination for the Influenza 2009-2010 season.

RESULTS

Rate of vaccination for hepatitis A in HCP was 28.8% (response rate 41.4%; 207/499), with 58.9% having completed the full series and 24.7% being tested for post-vaccination immunity. Acceptance rate among non-vaccinated subjects was 70.7%. HCP hepatitis A vaccination rate was statistically greater than the national general population (28.8 vs. 12.1%, p ≤ 0.031). A statistically significant greater vaccination rate was found among US born responders vs. foreign-born HCP (34.3 vs. 19.3%, p = 0.0324). Vaccination for hepatitis A was statistically inferior to that of Influenza (28.8 vs. 90%; P = 0.01).

CONCLUSIONS

HCP have statistically higher vaccination rate for hepatitis A than the general population, but overall protection remains suboptimal with vaccination rate below those for mandatory vaccines. Further studies to determine whether hepatitis A vaccine is cost-effective in HCP are recommended.

摘要

背景与目的

尽管有有效的疫苗可用,但甲型肝炎仍然是全球发病率和死亡率的一个重要原因,包括急性肝功能衰竭、移植和死亡。普通人群中甲肝疫苗的接种率较低。医护人员(HCP)中甲肝疫苗的接种率尚不清楚。我们研究了美国一家大型学术中心的 HCP 队列中甲肝疫苗的接种率。

材料与方法

我们在本机构有甲型肝炎暴露风险的 499 名 HCP 中分发了一份匿名调查。结果经过非应答率校正,并与使用 2007 年 CDC-国家免疫调查的一般美国人群进行比较。甲型肝炎疫苗接种率与 2009-2010 年流感季节机构的流感疫苗接种率进行比较。

结果

HCP 中甲肝疫苗的接种率为 28.8%(应答率为 41.4%;499/207),其中 58.9%完成了全程接种,24.7%检测了接种后的免疫效果。未接种疫苗的受试者的接受率为 70.7%。HCP 中甲肝疫苗接种率明显高于全国普通人群(28.8%比 12.1%,p≤0.031)。在美国出生的应答者中发现的疫苗接种率明显高于外国出生的 HCP(34.3%比 19.3%,p=0.0324)。甲型肝炎疫苗接种率明显低于流感(28.8%比 90%;P=0.01)。

结论

HCP 中甲肝疫苗的接种率明显高于普通人群,但总体保护仍不理想,接种率低于强制性疫苗。建议进一步研究 HCP 中甲肝疫苗是否具有成本效益。

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