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Hepatitis B vaccine responsiveness in Connecticut public safety personnel.

OBJECTIVE: To determine the level and determinants of vaccine response in recently inoculated public safety personnel. DESIGN: Prevalence survey. PARTICIPANTS: Public safety personnel who had completed vaccination 1 to 6 months prior to testing and had no serological evidence of previous exposure to hepatitis B virus. MAIN OUTCOME MEASURE: An inadequate level of antibody to hepatitis B surface antigen was defined as less than 10 mlU/mL. RESULTS: All subjects in the study had been vaccinated using Recombivax HB, a recombinant hepatitis B vaccine. Of 528 individuals, 11.9% were found to have no or inadequate levels of antibody. The frequency of inadequate level of antibody increased significantly relative to age, from 2.8% among those younger than 30 years to 42.1% among those older than 60 years (P < .0001). Smoking (odds ratio [OR], 3.6; 95% confidence interval [CI], 2.0 to 6.4), extreme obesity (OR, 13.3; 95% CI, 3.8 to 49.1), and increasing time interval since completing the vaccine series (P < .01) were also associated with inadequate levels of antibody. These findings were confirmed by multivariate analysis using logistic regression. CONCLUSIONS: Routine immunization of public safety personnel should include selective use of postvaccine testing. Postvaccination testing optimally should be performed in the 30- to 90-day interval after the last vaccine dose. New vaccination strategies are needed to improve response rates in persons with predictably poor response to hepatitis B vaccine.

Adult↗
PubMed1993

Tuberculin reactivity is low among residents of a Connecticut nursing home.

Of 131 residents of a suburban New England intermediate and skilled nursing facility, 126 agreed to be evaluated by two-stage administration of purified protein derivative (5TU) for tuberculin reactivity. Only eight patients (6.4%) had a positive reaction, considerably fewer than reported by most previous studies. There were no statistically significant differences between reactors and nonreactors based in age, gender, or length of stay in the facility. There was a tendency toward an association of presence of risk factors and a positive response to tuberculin skin testing, but this did not achieve statistical significance (P = 0.063).

Adolescent↗