Hepatitis B vaccine use in chronic hemodialysis centers in the United States.

The Centers for Disease Control surveyed 1,255 chronic hemodialysis centers in the United States in 1983 to assess the use of hepatitis B vaccine as well as the risk of acquiring hepatitis B among both patients and staff. The response rate to a mailed questionnaire was 90%. Seventy-one percent of the centers reported that they gave vaccine, but only an estimated 6% of susceptible patients and 32% of susceptible staff received all three doses of vaccine. Centers more likely to give vaccine included those that provided dialysis to large patient populations and those that provided dialysis for hepatitis B surface antigen-positive patients. As a result of vaccine administration, the overall prevalence of antibody to hepatitis B surface antigen increased significantly, to 18% for patients and 39% for staff. Extensive use of the vaccine in the future, combined with infection control practices, could virtually eliminate the risk of acquiring hepatitis B virus infection in hemodialysis centers.