Decline of clinical hepatitis B in workers at a general hospital: relation to increasing vaccine-induced immunity

Clin Infect Dis. 1993 Jan;16(1):10-4. doi: 10.1093/clinids/16.1.10.


Hepatitis B is a well-recognized occupational hazard of health-care workers that can be prevented with vaccination. However, because data on the current epidemiology of hepatitis B virus (HBV) in this population are limited, no consensus exists regarding the requirement for immunization. In 1980-1989, 4,908 exposures of health-care workers to patients' blood and/or other body fluids were reported and evaluated at a general hospital. During this period, 4.8% of patients to whom health-care workers were exposed were positive for hepatitis B surface antigen (HBsAg). In exposed workers, the rate of protective immunity to HBV (measured by antibody to HBsAg) increased from 14% in 1980 to 55% in 1989. Hepatitis B vaccine became available at this hospital in 1983. The increase in antibody to HBsAg was not associated with an increase in antibody to HBV core antigen; this finding suggests that the increase in immunity was primarily vaccine induced. The incidence of reported clinical hepatitis B in health-care workers decreased from 82/100,000 in 1980-1984 to zero in 1985-1989 (odds ratio = 20.06; P = .0012). Thus, in this study, a program of hepatitis B immunization for health-care workers was associated with a significant decline in clinical HBV infection despite continued exposure to patients positive for HBsAg.

MeSH terms

  • Hepatitis B / epidemiology
  • Hepatitis B / prevention & control*
  • Hepatitis B Surface Antigens / blood
  • Hepatitis B Vaccines / immunology*
  • Hospitals, General
  • Hospitals, University
  • Humans
  • Incidence
  • Occupational Diseases / epidemiology
  • Occupational Diseases / prevention & control*
  • Ohio / epidemiology
  • Personnel, Hospital*
  • Vaccination


  • Hepatitis B Surface Antigens
  • Hepatitis B Vaccines