Seroprotection to vaccine‐preventable diseases among workers at a Victorian tertiary hospital

Abstract

Objective: To determine seroprotection for the vaccine‐preventable diseases (VPDs) measles, mumps, rubella, varicella and hepatitis B among new employees seen at a Victorian tertiary hospital staff clinic. Methods: Employees who presented to the staff clinic for immunisation assessment between 1 January 2012 and 31 December 2013 were included. Demographic data, self‐reported disease history and previous vaccination status were reviewed retrospectively to determine impact on serological results. Results: A total of 1,901 new employees were included, 83% of whom were at risk of direct contact with blood or body substances. Overall, the proportion of workers seropositive to measles was 88%, mumps 90%, rubella 78%, varicella 93% and hepatitis B 80%. Staff born before 1966 were more likely to have positive measles or mumps serology but negative rubella or hepatitis B serology (p<0.05 for each). Staff who self‐reported measles (99% vs. 93%, p=0.03) or varicella infection (98% vs. 92%, p<0.001) were more likely to be seropositive, but those reporting previous vaccination to measles, mumps or rubella were no more likely to be seropositive. Conclusions and implications: This study demonstrated levels of seropositivity of 78–93% for the five VPDs. Despite recognised limitations of serological testing, 10–20% of new employees to a healthcare institution lacking seroprotection represents a potentially unacceptable risk of nosocomial transmission of these VPDs. Our findings support ongoing serological testing of new healthcare staff at risk of direct contact with blood or body substances.

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

“…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]. IgG antibodies after disease are often higher than after vaccination [3,20].…”

“…Varicella immunity was high with only eight (1.4%) seronegative HCW. Almost all were immune because of previous infection which may explain why their seroprevalence was higher than that found in vaccinated individuals [7,20].…”

“…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].…”

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

“…When not protected against vaccine-preventable diseases, they pose a risk to themselves and their patients, especially in an outbreak situation. Alarmingly, several studies have reported lacking immunity against vaccine-preventable diseases in HCWs [1][2][3].…”

Evaluation of testing and vaccination status of healthcare workers in Turkey for hepatitis A: A multicenter study

“…workers and patients. [2][3][4] Therefore, vaccination as well as following the protection measures against infections is important for healthcare workers to decrease the spread of infectious diseases and prevent transmission to other people.…”