Hepatite B: imunidade, efetividade da vacina e validação da medida de relato de vacinação entre acadêmicos da área da saúd

Abstract

Investigated immunity against hepatitis B (HB) and its associated factors were estimated the validity of reported vaccination, the magnitude of the factors associated with discordance between vaccination and registration account in the vaccination card and vaccine effectiveness among freshmen courses health Higher Education Institutions Claros-MG Montes, Brazil. This is a cross-sectional study, whose data were collected through a structured form. After vaccination observation in vaccine design immunity was evaluated by means of the blood anti-HBs dosage. The validity of reported vaccination was assessed by sensitivity, specificity, positive predictive value and negative and accuracy in accordance to the record in the vaccination card (gold standard). The agreement was measured by Kappa statistics and the magnitude of the association by Pearson correlation. The effectiveness of the vaccine was assessed by measurement of anti-HBs 60 days after vaccination scheme against HB between academic concomitantly not immune and unvaccinated. The dependent variables were immunity against HB and the disagreement between the vaccination account (account that has not been vaccinated and vaccination record of the card / account that has been vaccinated and no record of vaccination on the card). Independent were: demographic aspects partners, academic aspects, general health and health-related behaviors. Statistical analyzes were performed using the software PASW 18.0. The associations of the dependent variables with independent variables were investigated using bivariate and multivariate analysis using logistic regression. The study included 960 students, 690 (71.9%) had a vaccination card, 605 (63.0%) received at least one dose of vaccine. Among those who had card 490 (51.0%) dosed anti-HBs. 313 of these (32.6%) had received at least one dose of vaccine in the last 10 years. Among the 313 evaluated for immunity, 224 (71.6%) had anti-HBs of over 10 mIU / ml indicating they were immune. It found an association between the time elapsed after vaccination and immunity against HB, plus a dose response relationship between vaccination schedule and immunity. Immunity was lower among students with more study time and higher among those who have children, attended another college and are carriers of systemic disease. The vaccination report is considered valid (high specificity, high positive predictive value, smooth agreement and reasonable accuracy), but was inadequate to estimate the prevalence of vaccination. Disagreement was higher among younger people, who have never been exposed to sharps, among those whose families have more dependents and among students in nursing. This discrepancy increased with increasing body mass index (BMI). The vaccine was effective in 63 (90.0%) students. We conclude that immunity was 71.6%. HB vaccination report is valid and is in the same direction of the record, but may not reflect the reality. The effectiveness of the vaccine was satisfactory, but anti-HBs rate decreases with time. There is need for vaccination campaigns as well as awareness of the importance of the verification test of immunity after vaccination among health care academics. Scholars should be sensitized about the importance of immunization, maintenance of updated vaccination card and that the account of this vaccination may not be consistent with the record in the vaccination card.