Department of Infectious Diseases, Changhua Christian Hospital, Changhua, Taiwan.
Department of Infectious Diseases, Changhua Christian Hospital, Changhua, Taiwan; Department of Infection Control, Changhua Christian Hospital, Changhua, Taiwan.
J Microbiol Immunol Infect. 2023 Apr;56(2):274-281. doi: 10.1016/j.jmii.2022.09.005. Epub 2022 Oct 3.
Healthcare workers (HCWs) without evidence of immunity to varicella-zoster virus (VZV) are recommended to undergo varicella vaccination. Immunogenicity of live attenuated varicella vaccine has rarely been investigated among HCWs in Taiwan.
Anti-VZV immunoglobulin G (IgG) titer was checked for all HCWs at Changhua Christian Hospital from 2011 to 2017. One-dose and two-dose (separated by 4-8 weeks) vaccines were administered to HCWs with equivocal and negative anti-varicella IgG results, respectively. Follow-up anti-VZV IgG was determined at least 4 weeks after completion of vaccination. Factors associated with seroconversion to varicella vaccination were analyzed.
Among 2406 included HCWs, the anti-VZV IgG serostatus was tested positive, equivocal and negative in 1924 (79.9%), 117 (4.9%) and 365 (15.2%), respectively. The seroprevalence had decreased from 88.0% (235/267) in 2011 to 72.2% (270/374) in 2017 (p for trend <0.05). A total of 67.8% (327/482) HCWs completed scheduled vaccination and serological follow-up. The seroconversion rates for HCWs with baseline equivocal and negative anti-VZV IgG results were 100% (80/80) and 79.4% (196/247) after one- and two-dose vaccination, respectively. In multivariate analysis, obesity (adjusted odds ratio, 0.308; 95% confidence interval [CI], 0.11-0.94, p = 0.039) was the only factor statistically significantly associated with seroconversion to vaccination.
Decreasing trends of seroprevalence of VZV were observed among HCWs from 2011 to 2017. HCWs who were obese were less likely to respond to varicella vaccination.
建议没有水痘-带状疱疹病毒（VZV）免疫力证据的医疗保健工作者（HCWs）接种水痘疫苗。在台湾，很少有研究调查 HCWs 中活减毒水痘疫苗的免疫原性。
2011 年至 2017 年，对彰化基督教医院的所有 HCWs 进行了抗 VZV 免疫球蛋白 G（IgG）滴度检查。对于抗水痘 IgG 结果不确定和阴性的 HCWs，分别给予一剂和两剂（间隔 4-8 周）疫苗。接种疫苗后至少 4 周进行随访抗 VZV IgG。分析与水痘疫苗接种后血清转化率相关的因素。
在 2406 名纳入的 HCWs 中，1924 名（79.9%）、117 名（4.9%）和 365 名（15.2%）的抗 VZV IgG 血清状态分别为阳性、不确定和阴性。血清流行率从 2011 年的 88.0%（235/267）下降到 2017 年的 72.2%（270/374）（趋势 p<0.05）。共有 67.8%（327/482）的 HCWs 完成了计划的接种和血清学随访。基线抗 VZV IgG 结果不确定和阴性的 HCWs 在接受一剂和两剂疫苗接种后，血清转化率分别为 100%（80/80）和 79.4%（196/247）。多因素分析显示，肥胖（调整优势比，0.308；95%置信区间[CI]，0.11-0.94，p=0.039）是与接种疫苗后血清转化率相关的唯一统计学因素。
2011 年至 2017 年，HCWs 中 VZV 的血清流行率呈下降趋势。肥胖的 HCWs 对水痘疫苗的反应较低。
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