Acceptance of hepatitis B vaccine by workers in a Nigerian teaching hospital

Objectives: To determine the pattern of vaccine uptake by hospital personne l in a specifically designed pioneer hepatitis B vaccination programme and to highlight major lessons for ensuring success in future programmes, Design: A review of vaccination and employment records for a forty four-mon th period and comparative analysis on the basis of professional grouping an d work units. Setting: Obafemi Awolowo University Teaching Hospital Complex, Re-Be, Niger ia. Subjects: A total of 2,548 employees of the teaching hospital that have wor ked for a minimum of one year on a continuous basis between April 1992 and December 1995. Interventions: Procurement of recombinant hepatitis B vaccine (Engerix(R), SmithKline Beecham) by the hospital management and provision of the same to all interested employees of the teaching hospital at no cost under a vacci nation programme which was conducted on an on-site basis. Main outcome measures: 'Participation' in the vaccination programme was def ined as the uptake of at least one dose of hepatitis B vaccine, and 'compli ance' defined as the receipt of the three prescribed doses of the hepatitis B vaccine, Results: The level of participation in the vaccination programme was high w ith 91.9% of the target population of hospital workers receiving at least a dose of the vaccine, while only about half (53.8%) of the group complied w ith receiving the required three doses of the vaccine. In terms of particip ation, by professional grouping,laboratory workers and nurses recorded the lowest rates (82.5% and 84% respectively), while 100% participation was rec orded in respect of the staff of engineering, medical records, pharmacy and physiotherapy departments, The highest rate of compliance (receipt of thre e doses) was also found among non-clinical workers (medical record personne l -76.3% and engineering staff -69.5%) while the lowest rate was found amon g nurses (39.7%) and doctors (40.3%) Conclusion: Workers with the highest possibility of knowledge of, and expos ure to hepatitis B infection within the hospital setting - doctors, nurses, and laboratory workers - showed the greatest apathy to the vaccination pro gramme. Reasons for this trend demand close examination, and subsequently, identification of specific action that needs to be taken to improve the upt ake of the vaccine by the target population, particularly the high-risk gro ups, in future programmes. Among others, targeting all groups of workers wi th appropriate education on the infection; active involvement of profession al groups in the planning and execution of the vaccination programme; and r eview of the implementation logistics are some of the key points to note fo r future programmes.