Immunity against vaccine-preventable diseases in Finnish pediatric healthcare workers in 2015

Koivisto, Karoliina; Puhakka, Laura; Lappalainen, Maija; Blomqvist, Soile; Saxén, Harri; Nieminen, Tea

doi:10.1016/j.vaccine.2017.02.018

Cited by 21 publications

(22 citation statements)

References 36 publications

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“…Overall, protective levels of IgG were high for VZV, low for diphtheria and close to 90% for measles, mumps and rubella. A quarter of the HCW did not have IgG against at least one of the MMR components, which is in accordance with findings from Finland, where a quarter (39/157) of paediatric nurses had inadequate immunity to measles, mumps or rubella [4]. Lack of immunity was highest in the youngest HCW, a finding consistent with other studies [5][6][7].…”

Section: Discussionsupporting

confidence: 90%

“…The MMR vaccine is considered highly effective, but suboptimal long-term immunity and seronegativity in immunised individuals after two doses of MMR vaccine have been reported [2,3]. Studies in healthcare workers (HCW) from Europe, Japan and Australia found that 6-19% were seronegative to measles, 6-32% were seronegative to mumps and 3-22% were seronegative to rubella [4][5][6][7]. Paediatric HCW are at particular risk of work-related exposure and transmission of these previously common childhood diseases, and several countries have reported nosocomial outbreaks of measles, mumps, pertussis and varicella, involving both patients and HCW [8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Immunity to vaccine-preventable diseases among paediatric healthcare workers in Denmark, 2019

et al. 2021

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Background Healthcare workers (HCW) have been identified as index cases in disease outbreaks of vaccine-preventable diseases (VPD) in hospitals. Aim We investigated whether Danish paediatric HCW were protected against selected serious VPD. Methods We included 90% of staff members from two paediatric departments. All 555 HCW (496 women) supplied a blood sample for serology and filled in a questionnaire. Antibodies were measured with enzyme immunoassay against measles, mumps, rubella (MMR), varicella zoster, pertussis toxin and diphtheria toxin. Results Protective levels of IgG were found for measles (90.3%), mumps (86.5%), rubella (92.3%), varicella (98.6%) and diphtheria (80.5%). We found seropositivity for all three MMR components in 421 (75.9%) HCW, lowest in those younger than 36 years (63.3%). Only 28 (5%) HCW had measurable IgG to pertussis. HCW with self-reported immunity defined as previous infection or vaccination, had protective levels of IgG against measles, mumps, rubella and varicella in 87.4–98.8% of cases, not significantly higher than in those not reporting immunity. Previous history of disease had a high positive predictive value (PPV) of 96.8–98.8%. The PPV for previous vaccination ranged from 82.5% to 90.3%. In contrast, negative predictive values of self-reported history of disease and vaccination were remarkably low for all diseases. Conclusion The immunity gaps found primarily in young HCW indicate a need for a screening and vaccination strategy for this group. Considering the poor correlation between self-reported immunity and seropositivity, efforts should be made to check HCW’s immune status in order to identify those who would benefit from vaccination.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Immunity to vaccine-preventable diseases among paediatric healthcare workers in Denmark, 2019

et al. 2021

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“…In fact, in our study, most of the unprotected subjects become protected after receiving a booster dose of HBV vaccine. It is interesting to note the six subjects with lack of immunization after the booster dose had received a vaccination at the age of 12 years, a finding consistent with a more rapid decline of anti-HB titer among people vaccinated in infancy, as previously reported [49].…”

Section: Discussionsupporting

confidence: 81%

Persistence of Immunity for Hepatitis B Virus among Heathcare Workers and Italian Medical Students 20 Years after Vaccination

Coppeta

Pompei

Balbi

et al. 2019

IJERPH

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Background: Immunization of healthcare workers (HCWs) and medical students for the hepatitis B virus (HBV) is a crucial part of the hospital infection control programs. The aim of our study was to evaluate the persistence of anti-HBV specific antibodies in HCWs vaccinated during infancy or adolescence. Methods: Medical records of 734 consecutive subjects born after 1980 (481 females, 65.5% and 253 males, 34.5%) who underwent serological testing for anti-hepatitis B surface antibodies (anti-HBs) were evaluated. Results: A non-protective titer (<10 mUI) was found in 88/734 (12.0%) subjects; 84 (47.8%) of them received a booster dose of anti-hepatitis B vaccine and the anti-HBs titer of 58 subjects was measured 1 month after administration. A protective titer (anti-HBs >10 mIU/mL) was observed in almost 90% of subjects receiving the booster dose. Conclusions: A substantial percentage of HCWs had a non-protective anti-HBs titer at the time of the first employment, especially those vaccinated at birth age. However, the response to the booster dose showed that in these subjects, an anti-HBs titer <10 mIU/mL was due to the physiological decline of antibodies over the years. Therefore, primary immunization in childhood is highly effective and provides lasting immunity against HBV infection.

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“…(15,16) The mechanism relies in the theory that high HBsAb levels would neutralize the potential viral antigen coming from the HBcAb-positive grafts. (17,18) We adopted this strategy and showed similar results that a titer of HBsAb ≥ 1000 IU/L at the time of transplantation delayed the decay of HBsAb titer after transplantation and was associated with lower risk of de novo HBV infection in our pediatric population. However, the blood loss and transfusion during LT and the use of immunosuppressive agents led to the decay of HBsAb titer after transplantation.…”

Section: Original Article | 103mentioning

confidence: 87%

Prophylactic Strategy Against De Novo Hepatitis B Virus Infection for Pediatric Recipients Who Receive Hepatitis B Core Antibody–Positive Liver Grafts

et al. 2020

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The goal of this study was to evaluate the efficacy of a perioperative prophylactic strategy against de novo hepatitis B virus (HBV) infection in pediatric liver transplantation (LT) recipients with hepatitis B core antibody (HBcAb)-positive grafts. A total of 482 pediatric recipients transplanted between 2013 and 2017 were enrolled, and 170 recipients received HBcAbpositive liver grafts. The overall graft and recipient survival rates in HBcAb-positive and HBcAb-negative graft recipients were 91.8% versus 91.3% and 95.3% versus 94.2% at the end of follow-up. Preoperative hepatitis B surface antibody (HBsAb) titer ≥ 1000 IU/L and postoperative HBsAb titer ≥200 IU/L were our prophylactic targets for recipients receiving HBcAbpositive grafts. While 11 recipients developed de novo HBV infection, 10 received HBcAb-positive grafts. Both the preoperative and postoperative HBsAb targets were achieved in 78 recipients, the infection rate of de novo HBV was 1.3%; 24 recipients met the preoperative target, the infection rate was 4.2%; 52 recipients met the postoperative target, the infection rate was 1.9%; and 16 recipients met neither the preoperative nor postoperative HBsAb target, 43.8% of the recipients were infected with de novo HBV, which was significantly higher than the recipients who met both or either of the preoperative and postoperative targets. Split-liver grafts positive for HBcAb showed higher risk of de novo HBV infection. Postoperative application of lamivudine to recipients whose preoperative HBsAb titer < 1000 IU/L did not show preventive effect. Out of 11 infected recipients, 3 showed seroconversion under entecavir treatment. In conclusion, the graft and recipient survival rates were similar in pediatric LT recipients receiving HBcAb-positive or HBcAb-negative grafts. Our prophylactic strategy was effective for preventing de novo HBV infection in HBcAb-positive liver graft recipients.

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Immunity against vaccine-preventable diseases in Finnish pediatric healthcare workers in 2015

Cited by 21 publications

References 36 publications

Immunity to vaccine-preventable diseases among paediatric healthcare workers in Denmark, 2019

Immunity to vaccine-preventable diseases among paediatric healthcare workers in Denmark, 2019

Persistence of Immunity for Hepatitis B Virus among Heathcare Workers and Italian Medical Students 20 Years after Vaccination

Prophylactic Strategy Against De Novo Hepatitis B Virus Infection for Pediatric Recipients Who Receive Hepatitis B Core Antibody–Positive Liver Grafts

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