Barriers to Hepatitis B Vaccine Coverage among Healthcare Workers in the Republic of Georgia: An International Perspective

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http://www.journals.uchicago.edu/doi/abs/10.1086/649795

Infect Control Hosp Epidemiol 2010;31:158–164

© 2009 by The Society for Healthcare Epidemiology of America. All rights

reserved.

DOI: 10.1086/649795

Original Article

Barriers to Hepatitis B Vaccine Coverage among Healthcare Workers in the

Republic of Georgia: An International Perspective

M. Topuridze, MD, MS;

M. Butsashvili, MD, MS;

G. Kamkamidze, MD, PhD;

M. Kajaia, MD, MS;

D. Morse, MD, MS;

L. A. McNutt, PhD

From the Maternal and Child Care Union, Tbilisi, Georgia (M.T., M.B., G.K.,

M.K.); the New York State Department of Health (D.M.), and the School of Public

Health, University at Albany (D.M., L.A.M.), Albany, New York.

Background.While the Republic of Georgia has a high prevalence of hepatitis B

virus (HBV) infection (3.4% of blood donors tested positive for HBV surface

antigen [HBsAg]), relatively few healthcare workers (HCWs) are thought to be

immunized.

Objective.To measure rates of HBV vaccination coverage and identify predictors

of vaccine acceptance among HCWs.

Design.Crossâ€sectional survey.

Methods.A study was conducted among fullâ€time physicians and nurses at 2 large

hospitals. Selfâ€administered questionnaires included questions about

demographic characteristics, HBV vaccine status, willingness to recommend

vaccination to other HCWs, and barriers to vaccination. Laboratory tests were

conducted for identification of HBsAg and antibody to hepatitis B core antigen.

Results.A total of 297 (91%) of 325 randomly selected HCWs provided information

for the study (124 physicians and 173 nurses). The rate of HBV vaccination

coverage was 12%, and 54% of respondents indicated that they would recommend

vaccination to other HCWs. Perception of vaccine safety was identified as the

most important predictor for acceptance (prevalence ratio [PR], 3.3 [95%

confidence ratio {CI}, 1.2–8.9]) and for willingness to recommend HBV

vaccination to other HCWs (PR, 5.5 [95% CI, 3.1–9.4]). Vaccinated HCWs were

more likely to recommend vaccination to other healthcare personnel (PR, 1.7 [95%

CI, 1.5–2.1]), as were those younger than 40 years of age (PR, 6.0 [95% CI,

2.8–12.6]). Multivariate analyses identified 2 additional factors associated

with vaccine acceptance and willingness to recommend vaccination: the hospital

at which the HCW was employed and the perception of risk of infection for HCWs.

Conclusion.Georgia plans a major HBV vaccination campaign for HCWs in 2009. The

campaign’s success will depend on addressing vaccine safety concerns

identified in this study and educating HCWs about risk factors for infection and

benefits of immunization.

Received June 5, 2009; accepted August 7, 2009; electronically published

December 29, 2009.

Address reprint requests to M. Topuridze, Maternal and Child Care Union, 10a

Bakhtrioni Street, Tbilisi, Georgia (marina_topuridze@...)......

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