Journal Article•
Efficacy of Shanvac-B recombinant DNA hepatitis B vaccine in health care workers of Northern India.
15 Aug 2010-Hepatobiliary & Pancreatic Diseases International (Hepatobiliary Pancreat Dis Int)-Vol. 9, Iss: 4, pp 393-397
TL;DR: Recombinant indigenous vaccine Shanvac-B is highly efficacious in HCWs, and its immunogenicity is significantly higher in females than in males, however, pre-vaccination screening of HCWs is strongly recommended in India.
About: This article is published in Hepatobiliary & Pancreatic Diseases International.The article was published on 2010-08-15 and is currently open access. It has received 17 citations till now. The article focuses on the topics: Hepatitis B vaccine & Vaccination.
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TL;DR: Several factors contribute to the decline of the infection rate, including rising socioeconomic levels, increased access to clean water and the availability of a hepatitis A vaccine that was developed in the 1990s, particularly focusing on developing countries.
Abstract: Hepatitis B virus (HBV) infection is a serious global public health problem. The infection may be transmitted through sexual intercourse, parenteral contact or from an infected mother to the baby at birth and, if contracted early in life, may lead to chronic liver disease, including cirrhosis and hepatocellular carcinoma. On the basis of the HBV carrier rate, the world can be divided in 3 regions of high, medium and low endemicity. The major concern is about high endemicity countries, where the most common route of infection remains vertical transmission from mother to child. Screening of all pregnant women and passive immunization with human hepatitis B immunoglobulin are not affordable for many developing countries. The infection rate can be reduced by modifying behavior, improving individual education, testing all blood donations, assuring asepsis in clinical practice and screening all pregnant women. However, availability of a safe and efficacious vaccine and adoption of appropriate immunization strategies are the most effective means to prevent HBV infection and its consequences. The unsolved problem for poorest countries, where the number of people currently infected is high, is the cost of the vaccine. A future challenge is to overcome the social and economic hurdles of maintaining and improving a prevention policy worldwide to reduce the global burden of the disease.
525 citations
01 Jul 2014
TL;DR: Evidence was insufficient to make conclusions regarding whether several routinely recommended vaccines are associated with serious conditions such as multiple sclerosis, transverse myelitis, and acute disseminated encephalomyelitis; however, important factors must be taken into account when determining whether studies are warranted.
Abstract: Objectives To conduct a systematic review of the literature on the safety of vaccines recommended for routine immunization of children, adolescents, and adults in the United States as of 2011. Data sources We included placebo-controlled clinical trials and cohort studies comparing vaccinated and unvaccinated patients. We also included the following types of post-licensure analyses: case-control studies, self-controlled case series, and multivariate risk factor analyses. We conducted an electronic search of PubMed from inception through August 2013, and reviewed Advisory Committee for Immunization Practices statements, vaccine package inserts, and previously published reviews to identify studies. Scientific Information Packets were requested from vaccine manufacturers. Review methods We reviewed the methodology of the 2011 Institute of Medicine (IOM) consensus report "Adverse Effects of Vaccines: Evidence and Causality" and accepted their findings. We augmented their work with new studies and additional vaccines. For studies not included in the IOM report, we abstracted data on the presence or absence of adverse health outcomes, characteristics of patients, study design, and vaccine description, including brand, potency, dosage, timing, and formulation, where available. We excluded formulations not used in the United States. The McHarm instrument was used to evaluate the quality of adverse events collection and reporting in each study. We were unable to pool results; we rated the overall strength of evidence (SOE) as high, moderate, low, or insufficient by using guidance suggested by the Agency for Healthcare Research and Quality for its Effective Health Care Program. Results A total of 20,478 titles were identified; after title, abstract, and full-text review, 166 studies were accepted for abstraction. The vast majority of studies either did not investigate or could not identify risk factors for adverse events (AEs) associated with vaccination. Similarly, the severity of AEs was inconsistently reported, as was information that would make independent severity determination possible. SOE was high for the following associations in nonpregnant adults: seasonal influenza vaccine and arthralgia, myalgia, malaise, fever, pain at injection site; 2009 monovalent H1N1 vaccine and Guillain-Barre syndrome (GBS); and a lack of association between influenza and pneumococcal vaccines and cardiovascular events in the elderly. Risk of GBS was estimated at 1.6 excess cases per million persons vaccinated. SOE was high for the following associations in children and adolescents: measles, mumps, rubella (MMR) vaccine and febrile seizures in children under age 5; lack of association between MMR vaccine and autism spectrum disorders; and varicella vaccine and disseminated Oka strain varicella zoster virus with associated complications (i.e., meningitis, encephalitis) in individuals with demonstrated immunodeficiencies. There is moderate SOE that vaccines against rotavirus are associated with intussusception in children; risk was estimated as 1 to 5 cases per 100,000 vaccine doses, depending on brand. Moderate-strength evidence exists regarding human papillomavirus vaccine and a lack of association with onset of juvenile rheumatoid arthritis, type 1 diabetes, and GBS. Moderate-strength evidence shows no association between inactivated influenza vaccine and serious AEs in pregnant women.Evidence was insufficient to make conclusions regarding whether several routinely recommended vaccines are associated with serious conditions such as multiple sclerosis, transverse myelitis, and acute disseminated encephalomyelitis. Conclusions There is evidence that some vaccines are associated with serious adverse events; however, these events are extremely rare and must be weighed against the protective benefits that vaccines provide. Careful consideration should be given to the investigation of research gaps, including patient risk factors that may be associated with AEs; however, important factors must be taken into account when determining whether studies are warranted, including the severity and frequency of the AE being studied and the challenges of conducting sufficiently powered studies when investigating rare events.
37 citations
TL;DR: Investigation in healthcare workers in Iran found that the complete course of vaccination is sufficient for prevention of HBV and there is no need for booster dose or dose re-administration.
Abstract: Context: Despite various studies, there is no overall estimation about the efficacy of Hepatitis B virus (HBV) vaccine among healthcare workers (including healthcare personnel and healthcare students). The present meta-analysis study was conducted to investigate the efficacy of HBV vaccine in healthcare workers in Iran. Evidence Acquisition: This study was performed according to the PRISMA guidelines for systematic review and meta-analysis studies. A comprehensive search was conducted using national and international databases including: Magiran, Iranmedex, IranDoc, SID, Medlib, Scopus, Pubmed, Science Direct, Cochrane, Embase, Web of Science, Springer, wiley online library, Trials Register, DOAJ, and Google Scholar search engine without time limit up to 2016. Just papers which were qualified according to inclusion criteria were examined. The data were analyzed using meta-analysis method in STATA software Ver.11.1. Results: 1726 healthcare workers had been examined in 12 studies. The efficacy of HBV vaccine, 1 - 6 months after the injection of the third dose was determined to be 93.1% (95% CI: 90.3 - 97); this rate was 95.9% (95% CI: 93.1 - 98.6) for male and 91.3% (95% CI: 87.1% - 95.5%) for female participants. HBV vaccine efficacy was 90.9% (95% CI: 86.5-95.3) for 8 studies conducted on healthcare personnel and 97.3% (95% CI: 94.7-97.7) for 3 studies on healthcare students. Conclusions: Immunogenicity of HBV vaccine was 90 - 97 in healthcare workers. Hence, the complete course of vaccination is sufficient for prevention of HBV and there is no need for booster dose or dose re-administration.
19 citations
TL;DR: In this article, the authors identify fatores associados with a vacinacao contra hepatite B in trabalhadores da saude in Belo Horizonte, Brazil.
Abstract: OBJETIVO: Identificar fatores associados a vacinacao contra hepatite B em trabalhadores da saude. METODOS: Estudo transversal com 1.808 trabalhadores da saude do setor publico de Belo Horizonte, MG, em 2009. Questionario autoadministrado foi usado e a situacao vacinal foi analisada considerando caracteristicas sociodemograficas, estilo de vida, caracteristicas e condicoes de trabalho. Analises estatisticas univariada (p < 0,20) e multipla foram realizadas utilizando regressao de Poisson (p < 0,05) para avaliacao de fatores associados a vacinacao. RESULTADOS: Declararam ter sido vacinados 85,6% dos trabalhadores, 74,9% dos quais receberam esquema completo da vacina. Nao ter sido vacinado associou-se a nao ter companheiro, a escolaridade em nivel medio/tecnico ou superior incompleto e a caracteristicas do trabalho, como atuar na vigilância ou setor administrativo/servicos gerais e nao utilizar equipamentos de protecao individual. CONCLUSOES: Foram identificados grupos com menor cobertura vacinal. Sao necessarios esforcos para garantir o acesso e a adesao a vacinacao a todos os grupos ocupacionais.
17 citations
TL;DR: Occupation, education, and knowledge about HB seem to be associated with HBV vaccination, and 29% of hospital personnel were not vaccinated mainly due to negligence.
Abstract: Health care personnel are at high risk for hepatitis B virus (HBV) transmission. The aim of the present study was to investigate hepatitis B (HB) knowledge and vaccination acceptance among health care personnel in southwestern Greece, using the Hepatitis B Vaccine Knowledge and Acceptance Questionnaire. One hundred eighty-three employees participated (71 males). Occupation (p < .001), higher education (p < .001), and vaccination (p = .007) were significantly related to HB knowledge. The rate of HBV vaccination coverage was 70.9%. Participants considering themselves at high risk for HBV infection did not report significantly increased vaccination rates. In the multivariate analysis, university personnel (p = .002), occupational category (p < .001), and HB knowledge (p = .049) were significantly associated with vaccination. In conclusion, 29% of hospital personnel were not vaccinated mainly due to negligence. Occupation, education, and knowledge about HB seem to be associated with HBV vaccination.
16 citations