Hepatitis B virus vaccination compliance among health care workers in intensive care unit: necessity to improve protection of attending physicians

Excerpt

Sir: Health care workers (HCWs) in intensive care unit (ICU) are at higher risk of acquiring hepatitis B virus (HBV) infection through occupational exposure to blood and body fluids while accomplishing patient care duties. Their risk increases further because of frequent involvement in invasive procedures, often under imperative emergency situations when infection control precautions cannot be completely followed, and frequently the HBV status of the patient is unknown because of urgent admissions of critically ill patients through emergency department. This infection is vaccine preventable, but suboptimal compliance to vaccine among HCWs is a serious concern [1]. The present study is the subgroup analysis of larger hospital-wide investigation [2] undertaken to assess compliance to HBV vaccine and ensuing seroprotection among HCWs involved in direct patient care in ICU. This tertiary care center has a 12-bed ICU where round-the-clock intensive care is provided by 47 HCWs (12 physicians, 31 nurses and 4 nursing assistants). They were all negative for hepatitis B surface antigen at the time of joining the hospital. HCWs not having a protective level of anti-HBs (less than 10 mIU/ml) were advised to receive three doses (0, 1, 6 months) of HBV vaccine (each 1 ml dose containing 20 µg hepatitis B surface antigen). The recombinant HBV vaccine Engerix-B (Smith Kline Beecham Biological, Belgium) is provided free of cost by the hospital to all HCW’s. Those who received vaccine their anti-HBs level was checked after 3 months of last dose. …