Do Occupational Factors Affect the Immune Response to Hepatitis B Vaccination in Healthcare Workers?

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Background: Hepatitis B infection is a common blood-borne viral infection and a major public health problem, especially for health care workers. It is important to protect this group against this type of infection and vaccination is one of the most effective measures. Health care workers have some risk conditions such as shift work and stress in their occupational setting. Objectives: This study was conducted to recognize if occupational factors can affect the immune response to the hepatitis B vaccine. Methods: We enrolled 508 staff from three large teaching hospitals of Iran who received three standard doses of 20 µg of recombinant HB vaccine. Subjects who had anti-HBs titers < 10 mIU were injected with the second series of hepatitis B vaccine. Results: In this study, 451 (88.77%) subjects responded to the first series of HB vaccine. Moreover, 44 out of 57 participants, who had anti-HBs titers < 10 mIU after the first series of vaccination, responded to the second series of vaccination. This indicates that the rate of response to recombinant hepatitis B vaccine is nearly 97.44%. Some occupational factors were found to be associated with the low response to HB vaccine including job category, shift work, and working unit. Conclusions: To provide appropriate protection against hepatitis B infection for health care workers, in addition to vaccination, it may be helpful to provide appropriate shift work schedules to minimize sleep deprivation in them and consider a booster dose of the vaccine for health care workers who are physicians or work in critical units.