A Cross-Sectional Study on Anti Hepatitis B Immune Status in Vaccinated Healthcare Workers in the West Pomeranian Region of Poland

Background: hepatitis b vaccination, recommended for medical staff, has a non-response rate of 5% to 32%. in poland, there is no standardized postvaccination protocol to verify immunity.objectives: to determine the fraction of those who have been vaccinated against hbv (with a complete course followed/not followed by a booster) but not checked for serological evidence of hepatitis b immunity and to detect anti-hbs levels in this group by anonymous cross-sectional sero-survey.patients and methods: surgical/gynecological staff from 16 randomly selected hospitals in west pomerania, poland, were surveyed between july 2010-january 2011. eia system version 3.0 was used to detect anti-hbs.results: of 488 participants (439 females, median age 42 years) who were previously vaccinated (1-21 years ago), anti-hbs status was not determined after hbv vaccination in 361 individuals (74.0%; 95% ci: 69.9-77.7%), 5% (18/361) of whom had an anti-hbs titer of 0.0 miu/ml (12/18 who were given booster doses developed anti-hbs > 10 miu/ml) and 7.2% (26/361) of whom had an anti-hbs titer of 0.1-10 miu/ml. the multivariate logistic regression model revealed that working in a teaching hospital was associated with lower odds of not being checked for anti-hbs after hbv vaccination (or 0.22, 95% ci: 0.14-0.35; p = 0.0001).conclusions: the lack of a strict post-hbv vaccination policy to confirm immunity results in the majority of surgical/gynecological staff not checking their anti-hbs levels after hbv immunization. it is unknown whether the absence of current serological evidence of hepatitis b immunity can be attributed to non-response, the waning of vaccine-induced immunity, or preserved anamnestic response. the lack of a booster vaccination response in a fraction of subjects suggests that they are non-responders. strict post-vaccination testing to document immunity remains the key practice to detect non-responders among medical staff.