Poor uptake of hepatitis B immunization amongst hospital-based health care staff

The uptake of hepatitis B vaccine was assessed amongst 100 medical and 100 nursing staff in a teaching hospital with a policy of recommending to those at risk that they should seek immunization from their general practitioners. Sixteen per cent of nurses and 31% of doctors had completed a course of immunization with confirmation of seroconversion. An additional 9% and 18% respectively had been immunized without post-immunization serology. Ninety three per cent of nurses and 61% of doctors who had not been immunized would like to receive the vaccine. The commonest reasons for non-immunization amongst nurses were fear of vaccine and lack of advice, and amongst doctors, apathy and difficulty in obtaining the vaccine. Eighty seven per cent of medical staff and 57% of nurses had a history of needle stick injury. The low rates of vaccine uptake in this study combined with the high incidence of needle stick injury calls for a reappraisal of present hepatitis B vaccination programmes in hospitals. In particular the abrogation of responsibility for immunization to general practitioners is probably a major disincentive to potential vaccines.