Ibragimov Rafail, Nabirova Dilyara, Denebaeva Alfiya, Kurbanov Botirjon, Horth Roberta
Central Asia Field Epidemiology Training Program, Almaty, Kazakhstan.
Department of Medical and Preventive Care, Kazakh National Medical University Named After S. D. Asfendiyarov, Almaty, Kazakhstan.
Hum Vaccin Immunother. 2024 Dec 31;20(1):2435142. doi: 10.1080/21645515.2024.2435142. Epub 2024 Dec 18.
Healthcare workers (HCW) have high occupational risk for hepatitis B and Uzbekistan held two HCW vaccination campaigns in 2015 and 2022. Hepatitis B antibody testing (anti-HBs) after Hepatitis B (HepB) vaccination is recommended by the U.S. CDC and WHO for HCW, but Uzbekistan does not have such a policy. In 2023, we randomly selected HCW from the campaign registries. Participants who agreed were interviewed at their workplaces. Vaccination doses were self-reported. Testing for hepatitis B surface antigen (HBsAg), Total hepatitis B core antibody (anti-HBc), and anti-HBs were concurrently performed. We used multivariable Poisson regression to assess factors associated with anti-HBs ≥10 mIU/mL. Of 334 participants, 205 were vaccinated in 2015 and 129 in 2022. Median age was 40 years (interquartile range 35-49 years), and 87% were female. Most (71%) reported having completed the three doses, 21% two doses and 7% one dose. Testing revealed that 5% had an active HBV infection, 4% had a resolved infection, and 91% had detectable vaccine-derived antibodies. Among those ( = 303), 71% had anti-HBs ≥10 mIU/mL. For those who reported receiving 1, 2, and 3 doses, protective titers were 59%, 70%, and 72%, respectively. Protective titers were lower for HCW that worked in clinics versus hospitals (aPR = 0.92, CI: 0.87-0.98, = .01) adjusting for age, dose number and presence of chronic conditions. Strategies to improve completion of the 3-dose series and policies for post-vaccination immunity testing 1-2 months after completion of the 3-dose HepB series could help identify workers who may require revaccination or are currently infected.
医护人员感染乙型肝炎的职业风险较高，乌兹别克斯坦在2015年和2022年开展了两次医护人员疫苗接种活动。美国疾病控制与预防中心（CDC）和世界卫生组织（WHO）建议对医护人员进行乙型肝炎（HepB）疫苗接种后的乙型肝炎抗体检测（抗-HBs），但乌兹别克斯坦没有这样的政策。2023年，我们从活动登记册中随机挑选医护人员。同意参与的参与者在其工作场所接受访谈。疫苗接种剂量由参与者自行报告。同时进行乙型肝炎表面抗原（HBsAg）、乙型肝炎核心抗体（抗-HBc）和抗-HBs检测。我们使用多变量泊松回归来评估与抗-HBs≥10 mIU/mL相关的因素。在334名参与者中，205人在2015年接种了疫苗，129人在2022年接种。年龄中位数为40岁（四分位间距35 - 49岁），87%为女性。大多数（71%）报告已完成三剂接种，21%完成两剂，7%完成一剂。检测显示，5%有活动性HBV感染，4%有已痊愈感染，91%有可检测到的疫苗衍生抗体。在这些人（n = 303）中，71%抗-HBs≥10 mIU/mL。对于报告接种1剂、2剂和3剂的人，保护性抗体滴度分别为59%、70%和72%。在调整年龄、接种剂数和慢性病存在情况后，在诊所工作的医护人员的保护性抗体滴度低于在医院工作的医护人员（aPR = 0.92，CI：0.87 - 0.98，P = 0.01）。改进三剂系列疫苗接种完成率的策略以及在完成三剂HepB系列疫苗接种后1 - 2个月进行接种后免疫检测的政策，有助于识别可能需要重新接种或目前感染的工作人员。
