Hepatitis B vaccination coverage among health care workers in rural Kerala

Vani Srinivas, Tess Shajan, Sudheesh Muthuthodiyil Karippankunnath, Theertha Pradeep Reshmi, Vidhu Victor, Sreelakshmi Ravindran P.


Background: Hepatitis B is one of the most important blood borne infection, the health care workers may acquire while providing care to the patients. The overall aim of this study was to estimate the Hepatitis B vaccine coverage and its determinants among health care workers.

Methods: This cross-sectional study was done in a rural tertiary care hospital in Palakkad district, of Kerala. We particularly looked for self-reported hepatitis B vaccination coverage and its determinants, using self-administered pretested questionnaire in 410 health workers. We calculated the proportions and looked for association between the various independent variables and dependent variables for vaccination coverage.

Results: Out of 410 study participants, 119 (29%) of them were males and 291 (71%) of them were females. The mean age of the participant was 31.3 years and the range was between 19 to 70 years. 365 (89%) were vaccinated with atleast one dose of Hepatitis B Vaccine. Of these 306 (74.6%) had received all the 3 doses of vaccine, as per schedule. Gender and years of experience was not associated with the Hepatitis B vaccination status. However, variables like educational status, professional background was associated with hepatitis B vaccine coverage.

Conclusions: The coverage of hepatitis B vaccine was high. Among those with incomplete vaccination few of them were waiting for completing the vaccination schedule in near future. Good hospital policies like vaccinating the new medical students and new employees were the main factors responsible for high vaccination coverage among the health care workers in our study.


Hepatitis B, Vaccination, Health care worker, Kerala, India

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World Health Organisation. Global Hepatitis Report, 2017. Available from: https://www.who.i nt/hepatitis/publications/global-hepatitis-report 2017/en/. Assessed on 7 December 2020.

World Health Organisation. News room. Fact Sheets. Assessed on 7 December 2020.

Khakrkhar VM, T Rubee, Parchwani, Deepak N, Chirang P. Prevalence of Hepatitis B virus infection in HCWs of tertiary care hospital. National Journal of Medical Research.2012 June. 176-178. Available from: dkposzje))/reference/ReferencesPapers.aspx?ReferenceID=1549262. Assessed on 7 December 2020.

World Health Organisation. Regional Office of South East Asia. Regional strategy for the prevention and control of viral hepatitis. 2013.

World Health Organisation. WHO Hepatitis B factsheet. 2012. Assessed on 7 December 2019.

World Health Organisation. Health WorkForce. Human Resource for Health. Available from: Accessed on 17 December 2019.

Lewis JD, Enfield KB, Sifri CD. Hepatitis B in Health Care Workers: Transmission events and guidance by management. World Journal of Hepatology. 2015;7(3)488-97.

Elavia AJ, Banker DD. Hepatitis B virus infection in hospital personnel. Natl Med J India. 1992;5(6):265-8.

World Health Organisation, “Hepatitis B. Media centre” in Fact Sheet. 2015(204). Assessed on 17 December 2019.

Centers for Disease Control and Prevention. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. Morbidity and Mortality Weekly Report. Recommendations and Reports. 2018;67(1).

World Health Organization. WHO Headquarters. “The sample size determination”. 1993.

Immunization Action Coalition 1573 Selby Ave. St. Paul, MN 55104 ï (651) 647-9009 ï, Accessed on 17 December 2019.

Gopalakrishnan R, Ramamurthy S. Seroprevalence of Hepatitis B Infection among Health Care Workers and the Importance of Anti HBs Testing among the Health Care Workers. Int J Curr Microbiol App Sci. 2017;10.2280-85.

Sandesh K, Varghese T, Harikumar R, Beena P, Sasidharan VP, Bindu CS et al. Prevalence of Hepatitis B and C in the normal population and high-risk groups in north Kerala. Tropical gastroenterology. 2006;7(2):80-3.

Patil S, Kumar H, Nair R, Krishna S, Kumar A, Pillai B et al. Prevalence of HBV & HCV Infection and Adequacy of HBV Vaccination among Healthcare Workers – A Sero Epidemiological Survey and Knowledge, Attitude & Practice (KAP) Study. Kerala Medical Journal. 2016;9(4).

Pathak R, Chaudhary R, Pathania D, Ahluwalia SK, Mishra PK, Kahlon AS. Hepatitis B vaccine: Coverage and factors relating to its acceptance among health care workers of a tertiary care center in North India. International Journal of Medicine and Public Health. 2013;3(1):55-9.

Singhal V, Bora D, Singh S. Prevalence of Hepatitis B Virus Infection in Healthcare Workers of a Tertiary Care Centre in India and Their Vaccination Status. Journal of Vaccines & Vaccination. 2011;2(2):1000118.

Kumar HN, Nambiar RP, Mohapatra S, Khanna A, Praveen R, Bhawana DS. A cross sectional study on Hepatitis B vaccination status and Post-exposure prophylaxis Practices Among Health Care Workers in Teaching Hospitals in Manglore. Annals of Global Health. 2015;81.

Feleke BE. Low coverage of hepatitis B vaccine and determinants among health professionals working in Amhara regional state hospitals, Ethiopia. Journal of Public Health in Africa. 2016;7:553.

Ministry of Health and Family Welfare. National Viral Hepatitis Control Program Operational Guidelines, 2018. Government of India. Accessed on 17 December 2020.

World Health Organisation. Global health sector strategy on viral hepatitis 2016–2021. Towards ending viral hepatitis. 2016. hepatitis/strategy2016-2021/ ghss-hep/en/. Assessed on 7 December 2020.