Immune Response to anti-HBs Antibodies in Health Workers Following Hepatitis B Vaccination

According to Regulation No. 53 of 2015 of the Minister of Health of the Republic of Indonesia, a high risk of HBV infection in health workers is a problem that requires attention, and vaccination knowledge is critical to reducing these risk factors. Furthermore, because some people do not produce a sufficient antibody-forming (anti-HBs) response to HBsAg, testing for evidence of protective immunity against hepatitis B vaccination is required (Hepatitis B Surface Antigen). The purpose of the study was to determine the mapping of the characteristics of anti-HBs antibodies response after hepatitis B vaccination in health workers in terms of age, gender, ethnicity, smoking habits, obesity, vaccination frequency, last time of vaccination. Sixty vaccinated health workers were used to creating the research sample. Anti-HBs levels/titers in serum were measured using the Enzyme-Linked Immunosorbent Assay (ELISA) method, and a questionnaire was used to compile the data for this study. Age, gender, smoking, obesity, and vaccination dose were all used to map the outcomes of the anti-HBs antibody immune response study. Anti-HBs antibody response in health workers was graded as poor in 36 people (60%) and strong in 24 (40%). Regarding ethnic origin, lifestyle, obesity, and vaccination dose (frequency), there was no significant link between post-vaccination anti-HBs antibody response in health workers. In terms of age and gender, there is a strong association between post-vaccination anti-HBs antibody responses in health workers. Low antibody titers should be revaccinated to enhance anti-HBs titers, and health workers who smoke should quit because it reduces the levels of anti-HBs titers produced clinically.

Effect of a Community-Based Hepatitis B Virus Infection Detection Combined with Vaccination Program in China

Evidence on the effectiveness of hepatitis B virus (HBV) infection screening and vaccination programs remains rare in China. We used a quasi-experimental method, propensity score matching, to evaluate the effects of a community-based HBV infection detection combined with vaccination (HBVIDV) program in a pilot. Data were retrieved from the HBVIDV program implemented between July 2019 and June 2020. Outcomes were the difference between the treatment and control groups in hepatitis B vaccination (≥1 dose), hepatitis B vaccine series completion (≥3 doses), and serologic evidence of vaccine-mediated immunity. Altogether, 26,180 individuals were included, where 6160 (23.5%) individuals were assigned to the treatment group, and 20,020 (76.5%) individuals were assigned to the control group. After propensity score matching, 5793 individuals were matched. The rates of hepatitis B vaccination, hepatitis B vaccine series completion, and prevalence of vaccine-mediated immunity in the treatment and control groups were 29.0% vs. 17.8%, 22.1% vs. 13.1%, and 38.2% vs. 27.6%, respectively. The HBVIDV program was significantly associated with increased hepatitis B vaccination rate (OR, 1.884, 95% CI 1.725–2.057), hepatitis B vaccine series completion rate (OR, 1.872, 95% CI 1.696–2.065), and prevalence of vaccine-mediated immunity (OR, 1.623, 95% CI 1.501–1.755). The greater magnitude of association between HBVIDV program and outcomes was observed among adults aged 35–54 years and adults who live in rural areas. The HBVIDV program was effective in increasing the hepatitis B vaccination rate, hepatitis B vaccine series completion rate, and prevalence of vaccine-mediated immunity among adults in the pilot. Further focusing the program on special populations and regions may produce more effective results.

Promising Interventions to Prevent Liver Cancer in Idaho

Introduction: The Idaho Comprehensive Cancer Control Program (ICCCP) collaborated with the Idaho Immunization Program (IIP) to plan and implement activities to increase knowledge and awareness of liver cancer prevention through tailored hepatitis B immunization messaging to the Idaho community and health care providers. Purpose and Objectives: In this article, we report findings from an evaluation of these activities. Interventions Approach: The two programs implemented liver cancer prevention activities between May 2017 and December 2017; strategies included a social media vaccination awareness campaign and health care provider education. Evaluation Methods: Facebook Insights was used to report, and descriptive statistics were used to analyze, data from the social media campaign. Descriptive statistics were used to analyze data collected from a retrospective pre–post survey for the health care provider presentations and paired t-tests were conducted to detect differences between pre- and postexposure. Results: For the social media campaign, ICCCP and IIP posted a total of 32 liver cancer and hepatitis B vaccination posts on their respective Facebook pages, which reached 42,804 unique users. For the health care provider presentations, there was a statistically significant increase in awareness, knowledge, ability, and intention among health care providers. Implications for Public Health: Our evaluation serves as an example of how public health social media can reach consumers and how educating providers can raise awareness on the importance of hepatitis B vaccination as a means of preventing liver cancer.

Hepatitis B Vaccination in Advanced Chronic Kidney Disease: A Quality Improvement Project at a Veteran Affairs Chronic Kidney Disease Clinic

Hepatitis B vaccination is recommended in all patients with end-stage kidney disease (ESKD). However, only 50–60% of these patients achieve protective antibody levels if immunized after starting dialysis. Strategies to overcome this low seroconversion rate include a 6-month vaccination schedule starting earlier [chronic kidney disease (CKD) stage 4 and 5] to ensure immunity when patients progress to ESKD. We conducted a quality improvement program to immunize pre-dialysis patients. Patients who were found to have a negative baseline serology with a negative hepatitis B surface antibody level (HBsAb) were offered vaccination on a 6-month schedule (0, 1 and 6 months) with one of two available vaccines within the VA system (Recombivax™ or Engerix™). HBsAb titers were checked 3–4 months later, and titers ≥ 12 mIU/mL were indicative of immunity at VA. Patients who did not seroconvert were offered a repeat schedule of three more doses. We screened 198 patients (187 males and 11 females) with CKD 4 and 5 [glomerular filtration rate (GFR) < 29 mL/min/1.73 m2]. The median age of this cohort was 72 years (range 38–92 years). During the study period of 5 years (2015–2020), 10 patients were excluded since their GFR had improved to more than 30 mL/min/1.73 m2, 24 others had baseline immunity and 2 refused vaccination. The hepatitis B vaccination series was not started on 106 patients. Of the remaining 56, 12 patients progressed to ESKD and started dialysis before completion of the vaccination schedule, 6 expired and 1 did not come to clinic in 2020 due to the pandemic. Of the 37 patients who completed the vaccination schedule, 16 achieved seroconversion with adequate HBsAb titers, 10 did not develop immunity despite a second hepatitis B vaccination series, while 11 did not get a second series. Given the low seroconversion rate, albeit in a small cohort, vaccination should be considered in patients with earlier stages of CKD. Other options include studies on FDA approved vaccines of shorter duration. We plan to increase awareness among nephrologists, patients and nursing staff about the importance of achieving immunity against hepatitis B.