Varicella Seroprevalence in Healthcare Workers at a Medical Center Following Changes in National and Local Hospital Vaccination Policies
Abstract
:1. Introduction
2. Methods
2.1. Study Center and Population
2.2. Laboratory Values
2.3. Statistical Analysis
2.4. Ethical Certification
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
VZV IgG | Varicella zoster virus immunoglobulin G |
GMT | Geometric mean titer |
HCWs | Healthcare workers |
OR | Odds ratio |
CI | Confidence interval |
ACIP | Advisory Committee on Immunization Practices |
CDC | Centers for Disease Control and Prevention |
References
- Advisory Committee on Immunization Practices, and Centers for Disease Control and Prevention. Immunization of health-care personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. Morb Mortal Week Rep. Recomm. Rep. 2011, 60, 1. [Google Scholar]
- Yang, J.; Liu, J.; Xing, F.; Ye, H.; Dai, G.; Liu, M.; Lo, S.K.F.; Lau, R.W.T.; Chiu, K.H.Y.; Chan, J.F.W.; et al. Nosocomial transmission of chickenpox and varicella zoster virus seroprevalence rate amongst healthcare workers in a teaching hospital in China. BMC Infect. Dis. 2019, 19, 582–589. [Google Scholar] [CrossRef] [PubMed]
- Holmes, C.N. Predictive value of a history of varicella infection. Can. Fam. Phys. 2005, 51, 60–65. [Google Scholar] [PubMed]
- Department of Health. Notifiable Infectious Disease Statistics System; Center for Disease Control: Taipei, Taiwan, 2010.
- Lin, Y.H.; Huang, L.M.; Chang, I.S.; Tsai, F.Y.; Chang, L.Y. Disease burden and epidemiological characteristics of varicella in Taiwan from 2000 to 2005. J. Microbiol. Immunol. Infect. 2009, 42, 5–12. [Google Scholar] [PubMed]
- Promoting Routine Vaccination Against Varicella in Children from 2000 to 2012 on Epidemiology of Chickenpox in Taiwan. 2018. Available online: https://www.cdc.gov.tw/EpidemicTheme/Detail/zKNFqsVWxUoUqE6fyhmBNA?archiveId=jAo_FU_ZMdm79BORg9XmA (accessed on 8 July 2019).
- Wu, M.F.; Yang, Y.W.; Lin, W.Y.; Chang, C.Y.; Soon, M.S.; Liu, C.E. Varicella zoster virus infection among healthcare workers in Taiwan: Seroprevalence and predictive value of history of varicella infection. J. Hosp. Infect. 2012, 80, 162–167. [Google Scholar] [CrossRef] [PubMed]
- Apisarnthanarak, A.; Kitphati, R.; Tawatsupha, P.; Thongphubeth, K.; Apisarnthanarak, P.; Mundy, L.M. Outbreak of varicella-zoster virus infection among Thai healthcare workers. Infect. Control Hosp. Epidemiol. 2007, 28, 430–434. [Google Scholar] [CrossRef] [PubMed]
- Almuneef, M.; Dillon, J.; Abbas, M.F.; Memish, Z. Varicella zoster virus immunity in multinational health care workers of a Saudi Arabian hospital. Am. J. Infect. Control. 2003, 31, 375–381. [Google Scholar] [CrossRef]
- Lyznicki, J.M.; Bezman, R.J.; Genel, M. Report of the Council on Scientific Affairs, American Medical Association: Immunization of healthcare workers with varicella vaccine. Infect. Control Hosp. Epidemiol. 1998, 19, 348–353. [Google Scholar] [CrossRef] [PubMed]
- CDC, USA. Immunization of health-care workers: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep. 1997, 46, 1–42. [Google Scholar]
- Kim, S.H.; Park, S.H.; Choi, S.M.; Lee, D.G. Implementation of Hospital Policy for Healthcare Workers and Patients Exposed to Varicella-Zoster Virus. J. Korean Med. Sci. 2018, 33, e252–e265. [Google Scholar] [CrossRef]
- De Juanes, J.R.; Gil, A.; San-Martin, M.; Gonzalez, A.; Esteban, J.; Garcia de Codes, A. Seroprevalence of varicella antibodies in healthcare workers and health sciences students. Reliability of self-reported history of varicella. Vaccine 2005, 23, 1434–1436. [Google Scholar] [CrossRef] [PubMed]
- Long-Term National Immunity Survey 2007–2008. Available online: https://www.cdc.gov.tw/uploads/files/45d5e22c-8f0d-4928-b119-513129f9e7f6.pdf (accessed on 26 August 2019).
- Healthcare Personnel Vaccination Recommendations. Available online: https://www.cdc.gov.tw/File/Get/c1yM2ZCMNzRzxxdGXOTPjA (accessed on 26 August 2019).
- Gorny, A.W.; Mittal, C.; Saw, S.; Venkatachalam, I.; Fisher, D.A.; Tambyah, P.A. Varicella seroprevalence in healthcare workers in a tertiary hospital: An audit of cross-sectional data. BMC Res. Notes 2015, 10, 664–771. [Google Scholar] [CrossRef] [PubMed]
- Almuneef, M.; Memish, Z.A.; Abbas, M.E.; Balkhy, H.H. Screening healthcare workers for varicella-zoster virus: Can we trust the history? Infect. Control Hosp. Epidemiol. 2004, 25, 595–598. [Google Scholar] [CrossRef]
- Santos, A.M.; Ono, E.; Weckx, L.Y.; Coutinho, A.P.; de Moraes-Pinto, M.I. Varicella zoster antibodies in healthcare workers from two neonatal units in Sao Paulo, Brazil e assessment of a staff varicella policy. J. Hosp. Infect. 2004, 56, 228–231. [Google Scholar] [CrossRef] [PubMed]
- Vandersmissen, G.; Moens, G.; Vranckx, R.; de Schryver, A.; Jacques, P. Occupational risk of infection by varicella zoster virus in Belgian healthcare workers: A seroprevalence study. Occup. Environ. Med. 2000, 57, 621–626. [Google Scholar] [CrossRef] [PubMed]
- Haviari, S.; Bénet, T.; Saadatian-Elahi, M.; André, P.; Loulergue, P.; Vanhems, P. Vaccination of healthcare workers: A review. Hum. Vaccin. Immunother. 2015, 11, 2522–2537. [Google Scholar] [CrossRef]
- Riccò, M.; Cattani, S.; Casagranda, F.; Gualerzi, G.; Signorelli, C. Knowledge, attitudes, beliefs and practices of occupational physicians towards vaccinations of health care workers: A cross sectional pilot study in North-Eastern Italy. Int. J. Occup. Med. Environ. Health 2017, 30, 775–790. [Google Scholar] [CrossRef]
- David, J.W.; Martin, S.H.; Jennifer, M. Prevention and control of varicella-zoster virus in hospitals. Available online: https://www.uptodate.com/contents/prevention-and-control-of-varicella-zoster-virus-in-hospitals (accessed on 10 September 2019).
- Centers for Disease Control and Prevention. Prevention of varicella: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2007, 56, 1. [Google Scholar]
- Weber, D.J.; Rutala, W.A. Occupational health update: Focus on preventing the acquisition of infections with pre-exposure prophylaxis and postexposure prophylaxis. Infect. Dis. Clin. 2016, 30, 729–757. [Google Scholar] [CrossRef]
- Nettleman, M.D.; Schmid, M. Controlling varicella in the healthcare setting: The cost effectiveness of using varicella vaccine in healthcare workers. Infect. Control Hosp. Epidemiol. 1997, 18, 504–508. [Google Scholar] [CrossRef]
- O’Neill, J.; Buttery, J. Varicella and paediatric staff: Current practice and vaccine cost-effectiveness. J. Hosp. Infect. 2003, 53, 117–119. [Google Scholar] [CrossRef] [PubMed]
Age Group | Female | Male | Total | |||
---|---|---|---|---|---|---|
n | % | n | % | n | % | |
18–20 | 748 | 13.30 | 137 | 8.11 | 885 | 12.10 |
21–30 | 3632 | 64.57 | 1146 | 67.85 | 4778 | 65.33 |
31–40 | 787 | 13.99 | 305 | 18.06 | 1092 | 14.93 |
41–50 | 330 | 5.87 | 70 | 4.14 | 400 | 5.47 |
51–60 | 112 | 1.99 | 18 | 1.07 | 130 | 1.78 |
61–70 | 16 | 0.28 | 13 | 0.77 | 29 | 0.40 |
Total | 5625 | 1689 | 7314 |
Vocation | Age (Years) (Mean ± SD) | p-Value | n | Seroprevalence in % (Binominal 95% CI) | p-Value |
---|---|---|---|---|---|
Nurses | 24.82 ± 0.42 | <0.001 | 2826 | 88.9 (87.7–90.0) | <0.001 |
Doctors | 27.74 ± 0.38 | 1394 | 92.8 (91.4–94.2) | ||
Examination | 27.97 ± 0.12 | 481 | 93.2 (91.0–95.4) | ||
Preventive and long-term care service | 33.06 ± 0.24 | 226 | 91.5 (87.9–95.1) | ||
Administration | 25.87 ± 0.13 | 1702 | 91.0 (89.6–92.4) |
Variable | Odds Ratio | p-Value | 95 % CI | |
---|---|---|---|---|
Lower | Upper | |||
Gender | ||||
Female | 1.000 | - | - | - |
Male | 0.968 | 0.775 | 0.774 | 1.210 |
Birth-group | ||||
After 1 January 2003 | 1.000 | - | - | - |
Before 31 December 2002 | 2.506 | <0.001 | 1.902 | 3.515 |
Age-group | ||||
18–20 | 1.000 | |||
21–30 | 1.703 | <0.001 | 1.349 | 2.151 |
31–40 | 2.406 | <0.001 | 1.683 | 3.438 |
41–50 | 5.551 | <0.001 | 2.671 | 11.536 |
51–60 | 5.734 | <0.001 | 2.261 | 14.542 |
61–70 | ||||
Vocation | ||||
Doctors | 1.000 | - | - | - |
Nurses (ER, clinics) | 0.579 | 0.001 | 0.414 | 0.811 |
Nurses (wards) | 0.661 | 0.002 | 0.507 | 0.861 |
Examination | 0.975 | 0.902 | 0.650 | 1.462 |
Preventive and long-term care service | 0.747 | 0.259 | 0.450 | 1.240 |
Administration | 0.690 | 0.006 | 0.531 | 0.898 |
Variable | Odds Ratio | p-Value | 95 % CI | |
---|---|---|---|---|
Lower | Upper | |||
Year | ||||
(a) 2003–2007 (before policy) | 1.000 | |||
2008–2018 (after policy) | 1.456 | 0.052 | 0.967 | 2.345 |
(b) 2003–2007 (before policy) | 1.000 | - | - | - |
2008 | 2.036 | 0.046 | 1.283 | 4.216 |
2009 | 1.538 | 0.233 | 0.758 | 3.121 |
2010 | 1.392 | 0.361 | 0.685 | 2.829 |
2011 | 1.545 | 0.226 | 0.764 | 3.126 |
2012 | 1.577 | 0.207 | 0.777 | 3.199 |
2013 | 1.852 | 0.098 | 0.893 | 3.844 |
2014 | 2.088 | 0.049 | 1.100 | 4.360 |
2015 | 1.774 | 0.119 | 0.863 | 3.645 |
2016 | 1.477 | 0.288 | 0.720 | 3.028 |
2017 | 1.234 | 0.564 | 0.604 | 2.519 |
2018 | 1.056 | 0.889 | 0.491 | 2.271 |
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Tsou, M.-T.; Shao, H.-H. Varicella Seroprevalence in Healthcare Workers at a Medical Center Following Changes in National and Local Hospital Vaccination Policies. Int. J. Environ. Res. Public Health 2019, 16, 3544. https://doi.org/10.3390/ijerph16193544
Tsou M-T, Shao H-H. Varicella Seroprevalence in Healthcare Workers at a Medical Center Following Changes in National and Local Hospital Vaccination Policies. International Journal of Environmental Research and Public Health. 2019; 16(19):3544. https://doi.org/10.3390/ijerph16193544
Chicago/Turabian StyleTsou, Meng-Ting, and Hsin-Hui Shao. 2019. "Varicella Seroprevalence in Healthcare Workers at a Medical Center Following Changes in National and Local Hospital Vaccination Policies" International Journal of Environmental Research and Public Health 16, no. 19: 3544. https://doi.org/10.3390/ijerph16193544