Vivian Efua Senoo-Dogbey, Delali Adwoa Wuaku, Adiza Atoko Mumuni
Department of Public Health, School of Nursing and Midwifery, University of Ghana, P. O. Box LG 25 Legon, Accra, Ghana.
Ghana Institute of Management and Public Administration, Greenhill Campus, Accra, Ghana.
Vaccine X. 2023 Dec 10;16:100421. doi: 10.1016/j.jvacx.2023.100421. eCollection 2024 Jan.
The WHO and CDC recommend that HCWs who are at risk of HBV infection should vaccinate as adults early in their career by receiving 3 doses of HB vaccine at a schedule of months 0,1,6 and perform post-vaccination serological testing 1-2 months after vaccination. This study assessed adherence to all three components of the HBV vaccination program.
The study was a hospital-based analytical cross-sectional study involving 340 HCWs who were randomly selected. A pretested questionnaire was used to collect data which was analyzed using SPSS version 21. The proportion of HCWs adhering to the three components of the HBV vaccination protocol was computed. The multivariable analysis procedure identified the factors associated with overall adherence. Odds ratios were estimated with corresponding confidence intervals with the level of significance set at 0.05.
HBV vaccination coverage was 60.9 % and adherence to 3-doses, 0,1,6 vaccination schedules and post-vaccination serological testing were 46.8 %, 38 % and 13 % respectively. Overall adherence was intermediate at the population level with only 6.2 % of the study participants adhering to all three components of the HBV vaccination protocol. HCWs who had low-risk perception for HBV had the lowest odds of completely adhering to all three indicators recommended for HBV vaccination (aOR = 0.15; 95 %CI = 0.04-0.58). Also, male HCWs have lower odds of adhering to all three components of HBV vaccination compared to their female counterparts (aOR = 0.65; 95 %CI = 1.17-2.50).
Adherence to the three components of HBV vaccination recommended for HCWs is low in this study. Failure to receive the recommended three-dose series of HBV vaccine at the recommended 0,1,6 schedule has implications for achieving seroprotection or development of antibodies against HBV. Failure to perform post-vaccination testing 1-2 months after HBV vaccination has implications for timely PEP management following occupational exposures. All three components of an ideal HBV vaccination program are important and should be used collectively to guide facility led HCW vaccination programs. Occupational health and safety programs, Infection prevention and control, as well as health promotion campaigns in health facilities, should promote adherence to all three components of HBV vaccination programs.
世界卫生组织（WHO）和美国疾病控制与预防中心（CDC）建议，有感染乙肝病毒（HBV）风险的医护人员应在职业生涯早期作为成年人接种疫苗，按照0、1、6月的程序接种3剂乙肝疫苗，并在接种后1 - 2个月进行接种后血清学检测。本研究评估了乙肝疫苗接种计划所有三个组成部分的依从性。
该研究是一项基于医院的分析性横断面研究，随机选取了340名医护人员。使用经过预测试的问卷收集数据，并使用SPSS 21版进行分析。计算了医护人员对乙肝疫苗接种方案三个组成部分的依从比例。多变量分析程序确定了与总体依从性相关的因素。估计比值比及相应的置信区间，显著性水平设定为0.05。
乙肝疫苗接种覆盖率为60.9%，对0、1、6程序接种3剂疫苗、接种后血清学检测的依从率分别为46.8%、38%和13%。在人群层面，总体依从性处于中等水平，只有6.2%的研究参与者遵守乙肝疫苗接种方案的所有三个组成部分。对HBV风险认知较低的医护人员完全遵守所有三项推荐的HBV疫苗接种指标的几率最低（调整后比值比 = 0.15；95%置信区间 = 0.04 - 0.58）。此外，与女性医护人员相比，男性医护人员遵守HBV疫苗接种所有三个组成部分的几率较低（调整后比值比 = 0.65；95%置信区间 = 1.17 - 2.50）。
在本研究中，医护人员对推荐的乙肝疫苗接种三个组成部分的依从性较低。未按照推荐的0、1、6程序接种推荐的3剂乙肝疫苗系列，会影响实现血清保护或产生抗HBV抗体。在HBV疫苗接种后1 - 2个月未进行接种后检测，会影响职业暴露后及时的暴露后预防管理。理想的乙肝疫苗接种计划的所有三个组成部分都很重要，应共同用于指导医疗机构主导的医护人员疫苗接种计划。职业健康与安全计划、感染预防与控制以及医疗机构中的健康促进活动，应促进对乙肝疫苗接种计划所有三个组成部分的依从性。
