Hepatitis B immunization in UK renal units: failure to put policy into practice

A postal questionnaire survey of renal units, and an analytical study of surveillance data on acute hepatitis B were undertaken to discover the numbers of renal units (a) routinely immunizing staff and patients against hepatitis B and (b) with recent experience of managing patients with hepatitis B. Seventy-three (86%) of 85 units returned completed questionnaires. Most (63, 84%) of the responding units routinely immunized staff but only 4 (5%) routinely immunized patients. A third (25) of the units had treated at least one HBsAg-positive patient between 1987 and 1991, and 11 units had cared for at least one patient with acute hepatitis B. Units with recent experience of treating an HBsAg-positive patient were no more likely to immunize staff or patients than those without. Guidance on hepatitis B immunization of staff has generally been implemented by UK renal units; that on immunization of patients has not. Renal unit patients remain largely susceptible to hepatitis B and the potential for outbreaks remains. Renal units need further encouragement to implement fully guidance on immunization.