HBV Vaccination uptake at family medicine clinics in Poland: a cross-sectional sero-survey
Hepatitis B is a significant health burden in Poland with nosocomial transmission being the main source of infection. Therefore, HBV vaccination before surgery is widely recommended.
Objective: To assess the determinants of HBV vaccination uptake among patients attending family medicine clinics (FMC) and to establish their serological status in terms of HBV infection.
METHODS:
In March 2013 consecutive patients attending 3 randomly selected FMCs located in Zgorzelec region, Poland, completed an anonymous questionnaire on HBV vaccination history. Immunization status was based on self-reports, checked by the results of vaccination cards and anti-HBs titer. In those unvaccinated, serum samples were assayed for anti-HBc total with the use of third-generation testing methods.
RESULTS:
Response rate: 99.3%. Of 410 participants (66.1% females, median age 56 years), 55.4% (95%CI:50.5-60.1%) were previously vaccinated against HBV; in those 11.5% - with 2 doses of vaccine, 66.1% - with 3 doses,18.1% – with 4 doses. Elective surgery was the main reason (57.0%) for HBV immunization, 4.9% - were vaccinated due to recommendations by GPs. The multivariable regression model revealed that high educational status (OR 1.35), living in a city (OR 1.75), as well as having a surgery in the past (OR 2.93) were each associated with greater odds of being vaccinated. Anti-HBc total prevalence among those unvaccinated was 13.6% (24/176 95%CI:9.3%-19,5%). None of the patients had the history of clinical hepatitis B, none was aware of an infection.
CONCLUSIONS:
Low HBV immunization coverage among adult patients and the presence of serological markers of HBV infection among those unvaccinated call for comprehensive preventative measures against infection, including greater FMCs involvement. Although interventions should cover the whole population, low educated inhabitants living in the rural areas should be a group of special interest. Preoperative immunization against HBV seems to be an efficient tooll to increase the vaccination uptake.