Immune response to recombinant DNA [r-DNA] hepatitis B vaccine, in medical, dental and paramedical personnel, in the eastern province, Saudi Arabia

ABSTRACT

Three dose [20 ug/ml] of r-DNA Hepatitis B vaccine "ENGERIX-BR" were given [0-1-6 months] intervals, and post vaccination evaluation for anti-HBs were done three months after the 3rd dose. 96% [318 out of 331 vaccines] were sero-converted with high anti-HBs level > 100 IU/1. While 4% did not respond, those were revaccinated by booster doses. All of them-but one-sero-converted. Thus giving grand total immunization rate of 99.7% with high and/or medium [but acceptable] anit-HBs level. Regarding the 32 HBsAg positives that were not of course included in the vaccination program, 65.6% were positive for HBV markers [HBeAg and/or anti-HBe, HBcIgM, anti-HBc] indicative or recent infection with infectious, or potentially infectious status. These represented infection rates of 75%, 66.6%, 50% and 75% among doctors, nurses, med-technicians and ancillary services respectively. The main conclusion is to adopt vaccination of all medical and paramedical staff as they join their jobs, and four dose vaccination program is recommended with either r-DNA, or plasma derived HB vaccine [as both are interchangeably] at intervals 0-1-6-9 months interval even without post-vaccination. By the 3/4 dose policy 99.7% sero- conversion rate was reached with highly immunizing anti-HBs levels. A stress on the importance of following the universal precaution strategy for safety, by all the medical and paramedical staff is needed