Long-Term Persistence of Seroprotection by Hepatitis B Vaccination in Healthcare Workers of Southern Italy

Background

The impact of hepatitis B virus (HBV) vaccination campaigns on HBV epidemiology needs to be evaluated, in order to assess the long-term immunity offered by vaccines against HBV.

Objectives

To evaluate the current status of anti-HBV vaccine coverage among healthcare workers (HCWs) in Southern Italy, and to determine the long-term persistence of antibodies to hepatitis B surface antigens (anti-HBs) in such a cohort of subjects.

Patients and Methods

A longitudinal, retrospective seroepidemiological survey was conducted among 451 HCWs, who were working at or visiting, the Occupational Health Department of a city hospital, in Catania, Italy, between January 1976 and December 2010.

Results

At the 30-year follow-up (mean follow-up 10.15 ± 5.96 years, range 0.74-30), 261 HCWs had detectable anti-HBs titers indicating a persistence of seroprotection of 89.4% (out of 292 anti-HBs positive results, three months after vaccination). An inadequate vaccination schedule was the strongest predictor of antibody loss during follow-up (OR = 8.37 95% CI: 5.41-12.95, P < 0.001). A Kaplan-Maier survival curve revealed that the persistence of anti-HBs 30 years after vaccination, was 92.2% for high responders, while it was only 27.3% for low responders (P = 0.001).

Conclusions

A good level of seroprotection persisted in 57.9% of the subjects after 30 years. Factors related to this immunization status confirmed the importance of vaccinating HCWs early in their careers and ensuring an adequate vaccination schedule. However, with particular reference to the low rate of hepatitis B vaccine coverage among HCWs in Southern Italy, the implementation of a new educational intervention as part of an active vaccination program is needed.     

Effectiveness of the Comirnaty (BNT162b2, BioNTech/Pfizer) vaccine in preventing SARS-CoV-2 infection among healthcare workers,Treviso province,Veneto region,Italy, 27 December 2020 to 24 March 2021

Data on effectiveness of the BioNTech­/Pfizer COVID-19 vaccine in real-world settings are limited. In a study of 6,423 healthcare workers in Treviso Province, Italy, we estimated that, within the time intervals of 14–21 days from the first and at least 7 days from the second dose, vaccine effectiveness in preventing SARS-CoV-2 infection was 84% (95% confidence interval (CI): 40–96) and 95% (95% CI: 62–99), respectively. These results could support the ongoing vaccination campaigns by providing evidence for targeted communication.     

Lack of implementation of Hepatitis B Virus (HBV) vaccination policy in household contacts of HBV carriers in Italy

Background  

In Italy, HBV vaccination is recommended and offered free of charge through the National Health Service to selected population groups – e.g., family members of an HBsAg carrier, healthcare workers, newborns and those who were 12-years old in 1991. However, a significant proportion of cases of acute hepatitis B still occur in Italy among persons who should have been vaccinated. We analysed HBV sero-prevalence data of two vaccination target populations (people born after 1980 and household contacts of an HBV carrier) living in a southern Italian area in order to evaluate HBV vaccine coverage and its possible determinants.     

Long-term protection against carriage of hepatitis B virus after infant vaccination

BACKGROUND: Carriage of hepatitis B virus (HBV) is a major risk factor for liver cirrhosis and hepatocellular carcinoma. Infant vaccination has been effective in preventing horizontal transmission during early childhood. It is unknown whether protection is maintained into early adulthood. METHODS: In 1984, early childhood vaccination was introduced in 2 rural Gambian villages. In 2003, serological assessment of 81.5% of 1,350 eligible participants 1-24 years old was done, to determine vaccine efficacy against infection and carriage. RESULTS: Overall vaccine efficacy against infection and carriage was 83.4% (95% confidence interval [CI], 79.8%-86.6%) and 96.5% (85% CI, 93.9%-98.9%), respectively. Vaccine efficacy against infection was similar when restricted to primary responders (85.3%), but a significant effect of peak antibody concentration was found. Both vaccine efficacy and levels of hepatitis B surface antibody (anti-HBs) decreased with age, resulting in a vaccine efficacy against infection and carriage among 20-24-year-old participants of 70.9% (95% CI, 60.4%-80.5%) and 91.1% (95% CI, 75.8%-100%), respectively. Fifteen years after vaccination, fewer than half of the vaccinees had detectable anti-HBs. The prevalence of carriage in the unvaccinated population was similar to the prevalence 20 years earlier. CONCLUSIONS: HBV vaccination early during life can provide long-lasting protection against carriage, despite decreasing antibody levels. The role played by subclinical boosting and the necessity of a booster need to be evaluated.     

Couverture vaccinale contre l’hépatite virale B et prévalence de l’antigène HBs dans une profession à risque: étude transversale portant sur 244 sapeurs-pompiers de la ville d’Abidjan

Aim

To determine the vaccination coverage against hepatitis B virus and the prevalence of HBsAg among firefighters.

Materials and methods

This was a cross-sectional study conducted during a day of voluntary testing for HBsAg. All fire brigade members who attended were subjected to a questionnaire in interview form (age, sex, vaccination against hepatitis B virus), followed by a determination of HBsAg and the assay of transaminases (alanine aminotransferase level 40 IU/ml). When HBsAg was positive, all serological markers of hepatitis B were sought (Cobas ? Elisa) and quantitative determination of DNA hepatitis B (real-time PCR threshold 16 IU/ml; Roche Taqman?)

Results

Two hundred and forty-four firefighters have been received (average age: 45.69 years [extreme: 26–67 years], sex ratio = 80.33). One, two and three doses of hepatitis B virus vaccine were administered to 17 (7% [3.8–10.20]), 15 (6.1%[3–9.1]) and five (2%[1.98–3.75 CI 95%]) individuals, respectively. Vaccination coverage against hepatitis B virus infection was 2% (1.98–3.75 CI 95%). HBsAg was found in 32 of the 244 persons screened (prevalence 13.1% [08.87–17.34 CI 95%]). All patients were HBsAg positive HBeAg negative, anti-HBc IgMnegative and anti-HBc total positive. Aminotransferase above 40 IU/l and a viral load greater than 2,000 IU/ml were, respectively, found in ten (31.25%) and six (18.75%) of 32 patients with HBsAg positive.

Conclusion

The vaccination coverage against hepatitis B virus infection was low and the prevalence of HBsAg high in our study. Vaccination against hepatitis B preceded by a screening is recommended in Abidjan firefighters.     

Correlates of hepatitis B vaccination in a high-risk population: an Internet sample

PURPOSE: We sought to identify factors associated with hepatitis B virus vaccination, including knowledge and attitudes about hepatitis vaccination, and sexual and nonsexual risk behaviors among at-risk homosexual and bisexual men. SUBJECTS AND METHODS: Internet electronic communications were used to collect data from homosexual and bisexual men from the United States, using a 31-item online questionnaire accessible for 1 month.RESULTS: The mean (+/- SD) age of the 336 respondents was 38 +/- 11 years. Nearly 42% (142) reported at least one dose of vaccine; the remainder were completely unvaccinated. About 21% (n = 71) reported having no information about hepatitis. Approximately 72% (242) of respondents reported never using condoms during oral intercourse, and 26% (n = 87) reported using condoms during less than half of their episodes of anal intercourse. In multivariate analysis, variables associated with vaccination were younger age (odds ratio [OR] 0.7 per 10-year increase in age; 95% confidence interval [CI] 0.59 to 0.84, P = 0.002), high level of knowledge about the vaccine (OR 1.4; 95% CI: 1.03 to 1.83, P = 0.007), communication with a health-care provider about hepatitis (OR 1.98; 95% CI 1.31 to 2.98, P = 0.006), and professional training that included hepatitis education (OR 2.77; 95% CI 1.7 to 4.5, P = 0.001).CONCLUSIONS: Our findings underscore the need for health care providers to emphasize vaccine efficacy and safety, and to encourage high-risk patients to receive vaccination, particularly among men at high risk based on sexual and drug use behaviors.     

Social conformism and confidence in systems as additional psychological antecedents of vaccination: a survey to explain intention for COVID-19 vaccination among healthcare and welfare sector workers,France, December 2020 to February 2021

BackgroundThe start of the COVID-19 vaccination campaign among French healthcare and welfare sector workers in January 2021 offered an opportunity to study psychological antecedents of vaccination in this group.AimWe explored whether knowledge and attitude items related to social conformism and confidence in systems contributed to explaining intention for COVID-19 vaccination.MethodsWe developed a knowledge and attitude questionnaire with 30 items related to five established and two hypothetical psychological antecedents of vaccination (KA-7C). The online questionnaire was distributed from 18 December 2020 to 1 February 2021 through chain-referral via professional networks, yielding a convenience sample. We used multivariable logistic regression to explore the associations of individual and grouped KA-7C items with COVID-19 vaccine intention.ResultsAmong 5,234 participants, the vaccine intention model fit (pseudo R-squared values) increased slightly but significantly from 0.62 to 0.65 when adding social conformism and confidence in systems items. Intention to vaccinate was associated with the majority opinion among family and friends (OR: 11.57; 95% confidence interval (CI): 4.51–29.67) and a positive perception of employer’s encouragement to get vaccinated (vs negative; OR: 6.41; 95% CI: 3.36–12.22). The strongest association of a knowledge item was identifying the statement ‘Some stages of vaccine development (testing) have been skipped because of the epidemic emergency.’ as false (OR: 2.36; 95% CI: 1.73–3.22).ConclusionThe results suggest that social conformism and confidence in systems are distinct antecedents of vaccination among healthcare and welfare workers, which should be taken into account in vaccine promotion.     

HEPATITIS B VACCINATION COVERAGE AND POSTVACCINATION SEROLOGIC TESTING AMONG MEDICAL STUDENTS AT A PUBLIC UNIVERSITY IN BRAZIL

The aim of this cross-sectional study was to determine the hepatitis B vaccination coverage among medical students at a public university in Rio de Janeiro, Brazil, and their compliance with the postvaccination serologic testing recommendations. Of the total of 858 students, 675 (78.7%) participated in the study. Among the participants, 48.9% (95% CI: 45.1% to 52.7%) were vaccinated against hepatitis B (received ≥ 3 doses of the vaccine), 31.6% were not (received 0, 1 or 2 doses), and 19.6% did not know their vaccination status. Hepatitis B vaccination coverage increased from 26.0% among first-year students to 70.6% among sixth-year students while the prevalence of unknown vaccination status decreased from 39.7% among first-year students to 2.4% among sixth-year students. The frequency of unvaccinated students ranged from 23.7% among fifth-year students to 34.4% among first-year students. Only 34.8% of the vaccinated students performed the anti-HBs testing after vaccination. Among these medical students, we found a low adherence to the hepatitis B vaccination and to the postvaccination serologic testing. A comprehensive hepatitis B immunization program should be offered to students at this medical school.     

Epidemiological impact of mandatory vaccination against hepatitis B in Italian young adults

Background

Viral hepatitis caused by hepatitis B virus (HBV) is a leading cause of acute and chronic liver diseases worldwide.

Objectives

In Italy, a mandatory vaccination policy was introduced in 1991 and was established for all newborns and 12-year-old individuals. In 2004, vaccination of 12-yearold adolescents was discontinued, and that of infants was maintained.

Patients and Methods

We evaluated the seroprevalence of HBV markers in 806 individuals, who were vaccinated at birth or at 12 years of age, to assess the effectiveness of the national policy against HBV.

Results

The overall prevalence of anti-HBs antibodies was 90.32% (95% confidence interval [CI]: 88.28–92.36%); 2.23% (95% CI: 1.21–3.25%) of the subjects were positive for both antibodies to HBsAg (anti-HBs) and antibodies to hepatitis B core antigen (anti-HBc), whereas 5.83% (95% CI 4.21–7.45) of the subjects were negative for all markers tested. Further, 1.61% (95% CI: 0.74–2.48%) of the subjects were positive for hepatitis B surface antigen (HBsAg).

Conclusions

Our data provide additional evidence that HBV vaccination can confer long-term immunity when performed at birth and when performed for healthy adolescents; moreover, the results show the effectiveness of the application of a national vaccination strategy.     

COVID-19 vaccination among cirrhotics in Italy: High coverage and effectiveness of 3 doses versus 2 in preventing breakthrough infection and hospitalization

Background and AimsFew reports, all retrospective, have evaluated vaccine coverage against COVID-19 infection in cirrhotic subjects. No data are available for European Countries. We aimed to explore this topic and potential independent predictors of lack of vaccination.MethodsBetween January 1st and June 30th 2022, 1512 cirrhotic subjects of any etiology were consecutively enrolled in an observational - prospective study in 8 referral centers in Italy. Adjusted Odds Ratios (O.R.) for the association with lack of vaccination and with occurrence of breakthrough infection were evaluated by multiple logistic regression analysis.ResultsOverall vaccine coverage was 89.7% (80% among people born abroad). Among the 1358 vaccinated people, 178 (13.1%) had a breakthrough infection; of them 12 (6.7%) were hospitalized, but none died. Independent predictors associated with lack of vaccination were birth abroad, age <65 years and lower years of schooling. Child stage B/C was the only independent predictor of breakthrough infection. Occurrence of breakthrough infection was more likely reported in subjects who received 2 doses of vaccine than in those who received 3 doses (33.9% versus 9.0%; P<0.001).ConclusionHigh vaccine coverage against COVID-19 infection is observed among cirrhotic subjects in Italy. Vaccine is effective in preventing severe outcomes. Three doses are more effective than two, even in cirrhotic subjects.Lay SummaryThis large cohort study evidenced high vaccine coverage against COVID-19 infection among cirrhotic subjects in a European country and the effectiveness of vaccine in preventing severe outcomes. Three doses of vaccine are more effective than two in preventing breakthrough infection and hospitalization. Informative campaigns targeting people younger than 65 years of age and those with lower years of schooling may increase these excellent results.     

Vaccine coverage with hepatitis B and other vaccines in the Colombian Amazon: do health worker knowledge and perception influence coverage?

OBJECTIVES: We conducted a vaccination coverage survey in the Colombian Amazon, an area highly endemic for hepatitis B (HB), where HB vaccine was introduced in 1992. The aim was to measure vaccine coverage and factors influencing it, especially those related to health services. METHODS: A total of 3573 children younger than 11 years were randomly selected from four populations. Vaccination status was ascertained through the vaccination card and a questionnaire on socio-demographic factors was applied to children's caretakers. Health workers (HW) in charge of vaccination in rural and urban areas were interviewed regarding knowledge and practices in vaccination. Individual and HW characteristics were related to individual vaccination using logistic regression. RESULTS: Overall cumulated vaccination coverage was high for polio (96%, 95% CI: 94-98), measles (94%, 95% CI: 92.8-95.2), BCG (91%, 95% CI: 90-93), DPT (90%, 95% CI: 88-92) and HB (88%, 95% CI: 86-90). However, <50% of children completed the primary course of vaccination in the first year of life. Individual factors improving the likelihood of being either fully or HB vaccinated were: age>1 year, living in Leticia, being affiliated to the social security, and living in a house with a roof made of tiles rather than palm tree leaf. Among the variables related to HWs, poor knowledge of vaccine contraindications predicted a lower chance of being fully or HB vaccinated in the population served by them, even after controlling for individual variables. CONCLUSIONS: The HB control program in Colombia has achieved good coverage in one of the most endemic areas of the country. However, barriers to vaccination arise from inequities in the distribution of health insurance and inadequate HW knowledge.     

Association between smallpox vaccination and hepatitis C antibody positive serology in Pakistani volunteers

GOALS: To determine whether the smallpox vaccination program has significantly contributed to the widespread prevalence of hepatitis C infection in Pakistan. BACKGROUND: Hepatitis C virus has become a worldwide pandemic and has especially devastated developing nations such as Pakistan. There continues to be an increase in fatalities due to hepatitis C-related cirrhosis in Pakistan. STUDY: We studied 523 volunteers in the city of Lahore to determine whether the smallpox vaccination program, which ran from 1964 to 1982 in Pakistan, may be responsible for the national surge in hepatitis C viral infection, perhaps because of repetitive use of vaccination devices without proper sterilization or to contaminated vaccine contents. RESULTS: There was a significantly higher likelihood of hepatitis C antibody seroprevalence in individuals vaccinated for smallpox versus nonvaccinated individuals (21.0% vs. 4.6%, P < 0.001, age-adjusted odds ratio, 3.39; 95% confidence interval, 1.36-8.46). Subjects with positive hepatitis C serology were also more likely to have a history of transfusions (19.2% vs. 9.0%, P = 0.01), but anti-HCV positive serology was not significantly associated with a history of surgery or dental procedures. Following adjustment for age, sex, and history of other conditions, including transfusion, the association between prior smallpox vaccination and hepatitis C antibody seroprevalence remained strong and highly significant (multivariate adjusted odds ratio, 6.11; 95% confidence interval, 2.58-14.51). CONCLUSION: These results suggest that the widespread prevalence of hepatitis C infection in Pakistan may be an unintended consequence of the country's smallpox vaccination program and that blood transfusion is also a significant risk factor.     

Influenza vaccine coverage for healthcare workers in geriatric settings in France

BACKGROUND AND AIMS: Because of a relative lack of efficiency of influenza vaccine in the elderly population, influenza outbreaks in geriatric healthcare settings are probable, despite high influenza vaccination rates in patients. Nosocomial influenza outbreaks, more probably related to healthcare workers, have also been reported. Therefore, vaccination of healthcare workers is considered to be an important preventive policy, to decrease the in-hospital influenza burden during the viral circulation period. METHODS: This multicenter study measured influenza vaccine coverage of Health Care Worker in 102 geriatric healthcare settings (acute care, rehabilitation care, long-term care) by a first questionnaire. A second questionnaire assessed main factors associated with vaccine acceptance. RESULTS: 102 geriatric healthcare settings (20%) answered the first questionnaire. Vaccine coverage for physicians (n=187), nurses (n=631) and nurse assistants (n=1487) were 48.4%, 30.5% and 27.9%, respectively. Vaccination rates were correlated between occupational categories according to healthcare settings. Vaccination rates were significantly lower in acute care settings compared with rehabilitation and long-term care settings. Local recommendations was reported for 29.9%, but was not correlated with vaccine coverage. The second questionnaire showed that lack of motivation and knowledge, and organizational problems were the three main reasons for reluctance to be vaccinated. CONCLUSIONS: In French geriatric settings, influenza vaccine coverage of healthcare workers is low and highly variable, according to the type of healthcare setting. A group effect was found between occupational categories. However, the reasons for non-acceptance need further evaluation to improve HCW influenza vaccine coverage.     

Long-term efficacy of hepatitis B vaccination in healthcare workers of Oil Company Hospital, Tehran, Iran (1989-2005)

OBJECTIVE: This study was conducted to evaluate the 16-year efficacy of hepatitis B virus (HBV) vaccine in healthcare workers of Oil Company Hospital, Tehran, Iran. METHODS: Two hundred healthcare workers were enrolled in the study in 1989. All HBV markers were tested and those with positive HBV markers, positive antihepatitis C virus or anti-HIV were excluded from the study. The remaining participants received three doses of HBV vaccine and again all of our participants were reevaluated in 2005. Hepatitis B surface antigen (HBsAg), antihepatitis B surface antibody (anti-HBsAb), and antihepatitis B core antibody (anti-HBcAb) were checked in all participants and those with anti-HBcAb above 10 IU/l were excluded from the final evaluation. RESULTS: No participant was positive for HBsAg in either 1989 or 2005. Protective levels of anti-HBsAb were absent in all participants in 1989, but present in 67 (80.7%) participants in 2005 (P<0.001). Anti-HBsAb titer after vaccination was significantly higher in female participants than in male participants (P=0.01). Mean anti-HBsAb titer was 640+/-411.7 IU/l (range: 2-1000 IU/l) and the lowest protective titer was 12 IU/l. CONCLUSION: According to our results, 80.7% of our participants had a protective titer of anti-HBsAb 16 years after vaccination. Although all anti-HBc positive participants were free of clinical hepatitis and were negative for HBsAg, hepatitis B vaccination was proved to be highly effective in preventing clinically significant infection and chronic carrier status up to 16 years after the primary vaccination. Hence, HBV revaccination may not be mandatory in healthcare workers, according to their sufficient long-term level of anti-HBsAb.     

Low vaccination coverage for human papillomavirus disease among young men who have sex with men,France, 2019

BackgroundIn France, human papillomavirus (HPV) vaccination has been recommended in 2016 for men who have sex with men (MSM) up to age 26 years.AimWe aimed to estimate HPV vaccine coverage in 18–28 year-old MSM and identify uptake determinants.MethodsWe collected data on socio-demographic characteristics, sexual behaviour, sexually transmitted diseases (STI) screening and vaccination uptake using a voluntary cross-sectional online survey conducted in 2019 targeting MSM. We calculated coverage of at least one dose of HPV vaccine and prevalence ratios (PR) of determinants with 95% confidence intervals (CI) using Poisson regression.ResultsOf 9,469 respondents (age range: 18–28 years), 15% (95% CI: 14–16) reported being vaccinated for HPV. Coverage was significantly higher among MSM < 24 years (PR: 1.25; 95% CI: 1.13–1.39), with education level below university degree (PR: 1.12; 95% CI: 1.08–1.32), living in rural areas (PR: 1.21; 95% CI: 1.08–1.36), attending sex parties (PR: 1.12; 95% CI: 1.03–1.33), using HIV-related biomedical prevention methods (PR: 1.31; 95% CI: 1.12–1.54), with STI diagnosis (PR: 1.22; 95% CI: 1.08–1.38) and with hepatitis A or B vaccination (PR: 4.56; 95% CI: 3.63–5.81 vs PR: 3.35; 95% CI: 2.53–4.44).ConclusionsThe HPV vaccination uptake among MSM in France was not satisfactory. It was higher among MSM benefitting from other vaccinations and biomedical preventive methods against HIV, suggesting a synergistic effect of the national preventive sexual health recommendations for MSM. Further efforts to improve HPV vaccination coverage targeting MSM are warranted.     

The cost-effectiveness of universal vaccination of children against hepatitis A in Argentina: results of a dynamic health–economic analysis

Background Socioeconomic improvements can reduce levels of endemic hepatitis A, but conversely increase the burden of disease. Routine childhood vaccination can rapidly control hepatitis A infection rates through the induction of herd immunity, although such programs can be costly. Methods We evaluated the healthcare benefits and cost-effectiveness of a routine childhood vaccination program against hepatitis A in Argentina, using a dynamic model that incorporated the changing epidemiology of infection and the impact of vaccine-induced herd immunity. Demographic, disease, and economic data from Argentina were used where available. Results At 95% coverage, the program would reduce the number of hepatitis A infections by 352 405 annually, avoiding 121 587 symptomatic cases and 428 deaths. Substantial healthcare benefits were also observed with vaccination coverage as low as 70%, which would prevent 295 826 infections. Economically, the program would save US$23 989 963 annually at 95% coverage, equivalent to US$3 429 per life-year gained. The program remained cost-saving in response to variation in factors, including disease-related costs, discount rate, herd immunity level, and rate of decrease of force of infection. The break-even cost per vaccine dose for the society was US$25 in the base-case, more than three times the current public cost of US$7 per dose. Conclusions Routine childhood vaccination against hepatitis A showed both health benefits and robust economic benefits in this analysis, supporting the recent decision of the Argentine government to implement such a program.     

Helicobacter pylori is not a risk factor for hepatic encephalopathy.

BACKGROUND: Helicobacter pylori infection has been described as a risk factor for hepatic encephalopathy in patients with chronic liver disease although the topic remains controversial. AIMS: To determine whether Helicobacter pylori infection is an independent predictive factor for encephalopathy in patients with liver cirrhosis. METHODS: Clinical, epidemiological, analytical and nutritional parameters of 205 patients were collected. Helicobacter pylori infection was determined by serology. Encephalopathy (grade II or higher) was clinically assessed during follow-up. The relationship between each parameter and encephalopathy was analysed by Kaplan-Meier curves and the Log rank test. The most significant parameters underwent multivariate analysis by Cox regression. RESULTS: Twenty-five variables were related to encephalopathy in the bivariate analysis. Multivariate analysis selected five independent factors: previous bouts of encephalopathy (Odds ratio 3.79; 95% confidence interval 1.94-7.38), albumin (Odds ratio 0.86; 95% confidence interval 0.80-0.92), tricipital skin fold (Odds ratio 0.79; 95% confidence interval 0.66-0.95) chronic pulmonary disease (Odds ratio 2.78, 95% confidence interval; 1.31-5.92), and on-going alcoholism (Odds ratio 2.62; 95% confidence interval 1.16-5. BB). CONCLUSIONS: Helicobacter pylori is not an independent risk factor for hepatic encephalopathy.     

Antibody Responses to the BNT162b2 mRNA Vaccine in Healthcare Workers in a General Hospital in Japan: A Comparison of Two Assays for Anti-spike Protein Immunoglobulin G

Objective This study assessed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody responses to the BNT162b2 mRNA vaccine in Japanese healthcare workers. Methods In this prospective cohort study, participants received two doses of the BNT162b2 mRNA vaccine on days 0 and 21 and provided blood for anti-SARS-CoV-2 antibody testing before the first vaccine and on days 21 and 35 after vaccination. Anti-spike protein immunoglobulin G (S-IgG) was measured using Abbott and Fujirebio chemiluminescent immunoassays. Patients One hundred healthcare workers (median age: 39 years old, interquartile range: 30-48 years old), including 6 who had been previously infected with SARS-CoV-2 and 3 individuals taking immunosuppressive drugs, participated in the study. Results The S-IgG antibody titers (AU/mL) measured using both the Abbott and Fujirebio assays increased significantly (p＜0.001) over time, both with a prevalence of 100% at 35 days after the first vaccination. The multivariate log-normal linear regression analysis indicated the effect of immunosuppressant medication using both the Abbott (p=0.013) and Fujirebio (p=0.039) assays on S-IgG levels after complete vaccination. Pearson''s correlation coefficient between the Abbott and Fujirebio S-IgG results in all 300 samples collected before and after vaccination and 50 positive controls from patients with coronavirus disease 2019 were 0.963 [95% confidence interval (CI): 0.954-0.970, p＜0.001] and 0.909 (95% CI: 0.845-0.948, p＜0.001), respectively. Conclusion The BNT162b2 mRNA vaccine was effective at increasing S-IgG levels in Japanese immunocompetent healthcare workers. The Fujirebio S-IgG assay showed high diagnostic accuracy, using the Abbott S-IgG assay as the reference test.     

Epidemiology of hepatitis A in Valencia, Spain: public health implications

Summary. Between July 1988 and July 1989, sera from 1223 persons resident in the Valencia area of Spain were tested for antibodies against the hepatitis A virus. Sixty-five per cent of serum samples were positive for anti-HAV (95% confidence interval = 62.4–67.6). The prevalence of anti-HAV increased significantly with age (odds ratio 50 years = 69.8; 95% confidence interval = 26.5–183.4) and previous history of hepatitis A (odds ratio = 2.1; 95% confidence interval = 1.4–3.2). Prevalence decreased with higher educational level (odds ratio, university studies = 0.2; 95% confidence interval = 0.1–0.5). Overall, there has been a reduction of anti-HAV prevalence reflecting the decreasing exposure of the Spanish population to hepatitis A virus in recent years, particularly in the younger generations. The age of infection has increased, increasing the probability of future epidemics in groups previously protected by immunity acquired in early childhood. This new epidemiological pattern has strong public health implications, and universal childhood vaccination together with measures directed to improve sanitation may be the best public health strategy to protect the population.     

COVID-19 vaccination intention among healthcare workers in Vietnam

Objective:To assess the acceptance of coronavirus disease(COVID-19)vaccine among healthcare workers at two general hospitals in Vietnam when it is available.Methods:A cross-sectional study was conducted using a convenience sampling from January to February 2021 among 410 healthcare workers at two general hospitals in Vietnam via a selfadministered questionnaire.A multivariable regression analysis was performed to determine predictors of vaccine acceptance including the demographic factors,COVID-19 knowledge,and vaccine beliefs based on the domains of Health Belief Model.Results:Among 410 healthcare workers,76.10%showed vaccination willingness.Predictors of acceptance were determined that the group reporting as“vaccine acceptance”was more likely to be positive towards the perceived susceptibility and severity of COVID-19(OR 2.45;95%CI 1.48-4.06,P<0.05),perceived benefits of vaccination,and cues to action(OR 4.36;95%CI 2.35-8.09,and OR 5.49;95%CI 2.84-10.61,respectively,all P<0.001),but less likely to have the perceived barriers to vaccination(OR 0.19;95%CI 0.09-0.38;P<0.001)compared with the no acceptance group.Besides,people who had a good knowledge regarding the severity of illness were 3.37 times more likely to have identified as vaccine acceptance(OR 3.37;95%CI 1.04-10.86,P<0.05).The demographic factors were also associated with willingness to receive the vaccine,with participants who were staff and received COVID-19 information from relatives were less likely to accept the vaccine over those who were doctors and not receiving information from relatives(OR 0.36;95%CI 0.13-0.96,and OR 0.37;95%CI 0.17-0.78,respectively,all P<0.05).Conclusions:A rate of willingness to get vaccinated against COVID-19 was relatively high with discrepancies between occupation,receiving information from relatives,knowledge toward the severity of illness,and the elements of Health Belief Model.The findings will provide information for the management authorities to develop relevant interventions to promote COVID-19 vaccination uptake.