Assessment of hepatitis B virus immunization status among North American surgeons
P. S. Barie, E. P. Dellinger, S. H. Dougherty and M. P. Fink
Department of Surgery, Cornell University, New York, NY.
OBJECTIVE: We hypothesized that many surgeons have not been vaccinated
against hepatitis B virus (HBV), despite the existence of effective
recombinant vaccines. Prevalence of HBV vaccination among surgeons,
attitudes of those not vaccinated, estimated HBV infection rates, and
respondents' knowledge of the epidemiology of HBV exposure were determined.
DESIGN: Survey conducted by mail just before implementation of mandatory
HBV vaccination for health care workers. SETTING: Private and academic
general surgical, trauma and transplantation practices. PARTICIPANTS: Two
thousand one hundred twenty-five surgeons received the survey. Response
rates are as follows: in the Surgical Infection Society, 196 (50%) of 393
surgeons; in the American Association for the Surgery of Trauma, 223 (52%)
of 433 surgeons; in the American Society of Transplant Surgeons, 194 (44%)
of 438 surgeons; and among the Fellows of the American College of Surgeons,
403 (47%) of 861 surgeons. MAIN OUTCOME MEASURES: Prevalence of HBV
exposure and active immunization by specialty and society. RESULTS:
Prevalence of HBV exposure was 19.6%, was higher among trauma and
transplantation surgeons compared with general surgeons (P < .0001), and
increased significantly with age in all groups (P < .05). Despite
greater exposure, probable immunity was lower at an older age because young
surgeons (age, < 46 years) are more likely to be vaccines (P < .05).
Most surgeons (55%) were vaccinated more than 5 years ago; many recipients
of recombinant vaccines (26%) received an inadequate amount of vaccine or
were improperly vaccinated. Knowledge of the epidemiology was uniformly
poor, with rates of correct responses to the three questions below 50%.
CONCLUSIONS: Vaccination does not equal immunity. Between 38% and 50% of
practicing surgeons may not have adequate immunity to HBV.
