Predictive Factors of the Post-Vaccination Immune Response to Viral Hepatitis B in Medical Staff and Prospects for Optimizing Immunoprophylaxis Tactics
https://doi.org/10.52420/umj.25.4.7
EDN: HYGPTQ
Abstract
Introduction . Employees of medical organizations are a professional risk group for contracting bloodborne infections, which requires constant improvement of preventive measures, including optimization of approaches to the immunoprophylaxis of viral hepatitis B.
Materials and methods . In 2024–2025, the vaccination history and serological screening data of 1,380 medical organization employees for anti-HBs were analyzed. Laboratory tests were performed in the clinical and diagnostic laboratory of the UMMC-Health using enzyme immunoassay (the Vecto HBsAg-antibodies test system). Results . The proportion of people with anti-HBs ≥10 mIU/ml was 81.8 %. In binary logistic regression, prognostic factors affecting antibody concentrations were established: the age of employees, the period since the last vaccine was administered, and the number of vaccine doses ( p < 0.001). For modifiable factors, the linear regression model found that the concentration of anti-HBs decreased by 10.992 mIU/ml each year after immunization ( p < 0.001) and increased by 59.757 mIU/ml with each additional vaccine ( p < 0.001). Among the ROC curves, the model for the number of vaccines with a threshold value at the cut-off point was 4 (AUC = 0.745±0.018; 95 % CI: 0.709–0.781; sensitivity 83.2 %; specificity 57.0 %; p < 0.001).
Conclusion . The study made it possible to determine the prognostic factors affecting post-vaccination immunity to hepatitis B virus in medical workers, which justifies the need for further research to develop an optimal booster immunization strategy, taking into account a comprehensive analysis of the humoral and cellular immune response, clinical and anamnestic data and the general somatic status of staff.
Keywords
viral hepatitis B,
post-vaccination immunity,
antibodies,
anti-HBs,
prognostic factors,
medical professionals,
vaccination tactics,
optimization prospects
Supporting agencies: The study was carried out within the framework of the research work of the Ural State Medical University “Infections Related to the Provision of Medical Care in Medical Organizations: Risk Factors, Infection Control and Tools for Managing the Epidemic Process” (No. AAAA-A18-118022790023-5), the scientific program of European Medical Center “UMMC-Health” “An Integrated Approach to Risk Management of Hemocontact Infections Among Medical Personnel”, scientific research works of the Federal Research Institute of Viral Infections “Virom” of Rospotrebnadzor “Improving Epidemiological Monitoring of Healthcare-Associated Infections of Viral and Bacterial Etiology in the Ural and Siberian Federal Districts from the Standpoint of Genomic Epidemiological Surveillance” (No. 126021116957-7), “Assessment of the Prevalence of the Occult form of Hepatitis B in Certain Population Groups” (No. 126021116958-4).
About the Authors
T. A. Platonova
Ural State Medical University, Ekaterinburg; European Medical Center “UMMC-Health”; Federal Research Institute of Viral Infections “Virom” of Rospotrebnadzor
Russian Federation
Competing Interests:
Russian Federation
Tatyana A. Platonova – Doctor of Sciences (Medicine), Deputy Director for Academic Affairs, Associate Professor of the Department of Epidemiology, Social Hygiene and State Sanitary and Epidemiological Service Organization, Institute of Preventive Medicine; Head of the Scientific and Methodological Center, Head of the Epidemiological Department, Epidemiologist; Leading Researcher, Ural-Siberian Scientific and Methodological Center for the Prevention of Infections Associated with the Provision of Medical Assistance
Ekaterinburg
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest
M. S. Sklyar
European Medical Center “UMMC-Health”
Russian Federation
Competing Interests:
Russian Federation
Mikhail S. Sklyar – Doctor of Sciences (Medicine), General Manager
Ekaterinburg
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest
K. A. Korotkikh
Ural State Medical University; European Medical Center “UMMC-Health”
Russian Federation
Competing Interests:
Russian Federation
Ksenia A. Korotkikh – Resident of the Department of Epidemiology, Social Hygiene and State Sanitary and Epidemiological Service Organization, Institute of Preventive Medicine; Epidemiologist
Ekaterinburg
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest
A. M. Abakumova
European Medical Center “UMMC-Health”
Russian Federation
Competing Interests:
Russian Federation
Alena M. Abakumova – Epidemiologist
Ekaterinburg
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest
E. A. Karbovnichaya
European Medical Center “UMMC-Health”
Russian Federation
Competing Interests:
Russian Federation
Elena A. Karbovnichaya – Head of the Clinical Diagnostic Laboratory
Ekaterinburg
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest
A. Shayuk
European Medical Center “UMMC-Health”
Russian Federation
Competing Interests:
Russian Federation
Anton Shayuk – Clinical Laboratory Diagnostics Physician
Ekaterinburg
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest
References
1. Yakupova FM, Garipova RV, Gilmullina FS, Sozinova JM, Zagidov MM. Viral hepatitis B and C as occupational diseases. Medical Herald of the South of Russia. 2022;13(4):39–44. (In Russ.). DOI: https://doi.org/10.21886/2219-8075-2022-13-4-39-44.
2. Ostankova YuV, Serikova EN, Semenov AV, Bancevic MD, Filipovic-Vignjevic SB, Zueva EB, et al. Profile of hepatitis B virus mutations associated with HBsAg-negative disease in patients of hemodialysis centers. Problems of Particularly Dangerous Infections. 2021;(4):96–104. (In Russ.). DOI: https://doi.org/10.21055/0370-1069-2021-4-96-104.
3. Yuzhanina TS, Kukarkina VA, Golubkova AA, Podymova AS. Occupational risk of bloodborne infections among healthcare workers and strategies for their risk management. Fundamental and Clinical Medicine. 2025;10(2):32–43. (In Russ.). DOI: https://doi.org/10.23946/2500-0764-2025-10-2-32-43.
4. Ostankova YuV, Serikova EN, Zueva EN, Semenov AV. Hepatitis B virus — the probability of infection during medical care. In: Akimkin VG (ed.). Control and prevention of infections associated with health care (HAIs 2020). VIII Congress with international participation: Conference Abstracts. Moscow: Central Research Institute for Epidemiology; 2020. P. 92. (In Russ.). EDN: https://elibrary.ru/REJZTL.
5. Ostankova YuV, Bumbali S, Balde TAL, Esaulenko EV, Semenov AV, Zueva EN, et al. Chronic viral hepatitis B in healthcare workers in the Republic of Guinea. In: Gusev DA (ed.). Unresolved issues of etiotropic therapy of topical infections: Proceedings of the All-Russian Annual Scientific and Practical Conference. Saint Petersburg: Man and his Health; 2022. P. 263–264. (In Russ.). EDN: https://elibrary.ru/MDXCPU.
6. Petrov IA, Chernavskiy AF, Tokareva UA. Integrational method in complex model formation of quality management of medical car. Ural Medical Journal. 2018;(7):192–197. (In Russ.). EDN: https://elibrary.ru/ASMNPY.
7. Alkhaldi S, Aldousari H, Alfaresi S, Alqabandi S, Khafagi W, Sheha M, et al. Measuring immunoglobulin titers among healthcare workers after hepatitis B vaccination: A cross-sectional study in Kuwait. Cureus. 2024;16(7): e64910. DOI: https://doi.org/10.7759/cureus.64910.
8. Polyanina AV, Korneva AA, Kashnikova AD, Latsples OA. Monitoring studies of post-vaccination immunity to the hepatitis B virus of employees of the anti-tuberculosis service of the Nizhny Novgorod region. Medical Almanac. 2024;81(4):103–110. (In Russ.). EDN: https://elibrary.ru/ISPWCX.
9. Skvoroda VV, Esaulenko, EV. Study of immunity against hepatitis B in persons vaccinated with various vaccination schemes. In: Gorodin VN, Zhukova LI, Lebedev PV (eds.). Socially significant and especially dan gerous infectious diseases: Proceedings of the XI All-Russian Interdisciplinary Scientific and Practical Confer ence with international participation. Krasnodar: PH “Novatsiya”; 2024. P. 185–187. (In Russ.). EDN: https://elibrary.ru/GVSGCA.
10. Sharova AA, Ivanova NV, Esaulenko EV, Danilova EM. Results of examination of medical workers for hepatitis B virus markers. Medicine: Theory and Practice. 2019;4(Suppl):609–610. (In Russ.). EDN: https://elibrary.ru/BQOWRC.
11. Asratyan AA, Musina EE, Novikova YuB, Shulyak YuA, Demidovich LI, Kotova IYu, et al. Assessment of the intensity and duration of post-vaccination immunity against hepatitis B in medical personnel of a large narcological hospital. Epidemiology and Vaccine Prevention. 2011;(3):64–69. (In Russ.). EDN: https://elibrary.ru/NUUZRJ.
12. Amaral TS, Alves CMDS, Rezende FR, Caetano KAA, Tipple AFV. Serological and vaccine evaluation for hepatitis B among Community Health Workers. Revista Latino-Americana de Enfermagem. 2023;31:e3765. DOI: https://doi.org/10.1590/1518-8345.6107.3765.
13. Korneva AA, Polyanina AV. Assessment of the state of post-vaccination immunity against hepatitis B in Nizhny Novgorod medical workers. In: Vdovina LV (ed.). “VolgaMedCase”: Collection of abstracts of the I Interregional interdisciplinary scientific and practical conference on the results of industrial practice with international participation. Nizhny Novgorod: Privolzhsky Research Medical University; 2022. P. 180–182. (In Russ.). EDN: https://elibrary.ru/JVKCNC.
14. Mamkeev EH, Lokotkova AI, Reshetnikova ID, Karpenko LG, Bulycheva IA. On post-vaccination humoral immunity against viral hepatitis B in medical workers in the Republic of Tatarstan. Medical Almanac. 2019;(3–4):61–64. (In Russ.). EDN: https://elibrary.ru/OMCGHU.
15. Bianchi FP, Stefanizzi P, Migliore G, Martinelli A, Vimercati L, Germinario CA, et al. Prevalence of healthcare workers fully vaccinated against hepatitis B without circulating antibodies in Italy and role of age at baseline cycle vaccination: A systematic review and meta-analysis. Expert Review of Vaccines. 2023;22(1):139–147. DOI: https://doi.org/10.1080/14760584.2023.2162507.
16. Fischinger S, Boudreau CM, Butler AL, Streeck H, Alter G. Sex differences in vaccine-induced humoral immunity. Seminars in Immunopathology. 2019;41(2):239–249. DOI: https://doi.org/10.1007/s00281-018-0726-5.
17. Ruggieri A, Anticoli S, D’Ambrosio A, Giordani L, Viora M. The influence of sex and gender on immunity, infection and vaccination. Annali dell’Istituto Superiore di Sanita. 2016;52(2):198–204. DOI: https://doi.org/10.4415/ANN_16_02_11.
18. Flanagan KL, Fink AL, Plebanski M, Klein SL. Sex and gender differences in the outcomes of vaccination over the life course. Annual Review of Cell and Developmental Biology. 2017;33:577–599. DOI: https://doi.org/10.1146/annurev-cellbio 100616-060718.
19. Shulgina NI, Stasenko VL. Assessment of duration and intensity of post-vaccination humoral immunity to hepatitis B patients decreed groups. Epidemiology and Vaccine Prevention. 2011;(1):68–73. (In Russ.). EDN: https://elibrary.ru/NDIHKD.
20. Kochetova EO, Shamsheva OV, Polesko IV, Semenenko AV, Maiorova OA, Belyakova VV, et al. Features of the formation of specific immunity after vaccination against viral hepatitis B in children and young people. Lechaschi Vrach. 2023;(6):7–15. (In Russ.). DOI: https://doi.org/10.51793/OS.2023.26.6.001.
21. Vasić SB, Svitlica BB, Milutinović D, Stevanović G, Maletić JS, Savić N, et al. Factors predicting the level of vaccine protection against hepatitis B virus infection among physicians and nurses in Šabac, Serbia. Archives of Industrial Hygiene and Toxicology. 2024;75(3):191–199. DOI: https://doi.org/10.2478/aiht2024-75-3828.
22. Korneva AA, Novoselova AA, Kashnikova AD. Study of post-vaccination immunity against hepatitis B in medical staff of a tuberculosis dispensary. In: Popova AYu. (ed.). Modern problems of epidemiology, micro biology and hygiene: Proceedings of the XVI All-Russian scientific and practical conference of young scientists and specialists of Rospotrebnadzor. Ekaterinburg: Medical Research Center for Prophylaxis and Health Protection of Industrial Workers; 2024. P. 65–66. (In Russ.). EDN: https://elibrary.ru/PTHVHF.
23. Magomedova NA, Kostinov MP, Khrapunova IA, Linok AV, Loktionova MN. Anti-HBs levels in health care workers vaccinated against hepatitis B. Infectious diseases. 2025;23(1):32–39. (In Russ.). EDN: https://elibrary.ru/DSPKDI.
24. Minaeva VA, Golubkova AA. Medical exemptions from vaccinations. Structure, validity and compromise. In: Akimkin VG (ed.). Modern immunoprophylaxis: Challenges, opportunities, prospects: Abstracts of the VI All-Russian scientific and practical conference with international participation. Moscow: Central Research Institute of Epidemiology; 2023. P. 82–83. (In Russ.). EDN: https://elibrary.ru/JUYFTC.
25. Korneva AA, Polyanina AV, Zaitseva NN. Evaluation of the effectiveness of post-vaccination immunity against hepatitis B among the medical staff of surgical departments. Infectious diseases in the modern world: evolution, current and future threats: Proceedings of the XV Annual All-Russian Congress on Infectious Diseases named after Academician V.I. Pokrovsky. Moscow: Medical Marketing Agency; 2023. 107 p. (In Russ.). EDN: https://elibrary.ru/FRKQTF.
26. Turaev RG, Eremeeva ZhG, Ilina NV, Khakimova RI, Mulyukova AN, Fazylov VK, et al. Evaluation of post-vaccination immunity to hepatitis B in workers of the republican blood center. Transfusiology. 2019;20(4):336–345. (In Russ.). EDN: https://elibrary.ru/TZUXMS.
27. Eesaulenko EV, Prijma EN, Skvoroda VV, Vetrov VV, Remizov MM, Trifonova GF, et al. Immunological efficacy of hepatitis B vaccine. Journal Infectology. 2025;17(2):135–142. (In Russ.). DOI: https://doi.org/10.22625/2072-6732-2025-17-2-135-142.
28. Lopatukhina MA, Oorzhak ND, Kyuregyan KK, Mikhailov MI. Immunological effectiveness immunization hepatitis B in the republic of Tyva after 30. In: Akimkin VG (ed.). Modern immunoprophylaxis: Challenges, opportunities, prospects: Collection of abstracts of the VI All-Russian Scientific and practical conference with international participation. Moscow: CSRI of Epidemiology of Rospotrebnadzor; 2025. P. 31–32. (In Russ.). EDN: https://elibrary.ru/MJTIMC.
29. Mahmood S, Shah KU, Khan TM. Immune persistence after infant hepatitis-B vaccination: A systematic review and meta-analysis. Scientific Reports. 2018;8(1):12550. DOI: https://doi.org/10.1038/s41598-018-30512-8.
30. Bini C, Grazzini M, Chellini M, Mucci N, Arcangeli G, Tiscione E, et al. Is hepatitis B vaccination performed at infant and adolescent age able to provide long-term immunological memory? An observational study on healthcare students and workers in Florence, Italy. Human Vaccines & Immunotherapeutics. 2018;14(2):450–455. DOI: https://doi.org/10.1080/21645515.2017.1398297.
31. Dini G, Toletone A, Barberis I, Debarbieri N, Massa E, Paganino C, et al. Persistence of protective anti-HBs antibody levels and anamnestic response to HBV booster vaccination: A cross-sectional study among healthcare students 20 years following the universal immunization campaign in Italy. Human Vaccines & Immuno therapeutics. 2017;13(2):440–444. DOI: https://doi.org/10.1080/21645515.2017.1264788.
32. Wang ZZ, Gao YH, Lu W, Jin CD, Zeng Y, Yan L, et al. Long-term persistence in protection and response to a hepatitis B vaccine booster among adolescents immunized in infancy in the western region of China. Human Vaccines and Immunotherapeutics. 2017;13(4):909–915. DOI: https://doi.org/10.1080/21645515.2016.1250990.
33. Banatvala JE, Van Damme P. Hepatitis B vaccine — do we need boosters? Journal of Viral Hepatitis. 2003;10(1):1–6. DOI: https://doi.org/10.1046/j.1365-2893.2003.00400.x.
34. Zanetti AR, Mariano A, Romanò L, D’Amelio R, Chironna M, Coppola RC, et al. Long-term immunogenicity of hepatitis B vaccination and policy for booster: An Italian multicentre study. The Lancet. 2005;366(9494):1379–1384. DOI: https://doi.org/10.1016/S0140-6736(05)67568X.
35. Khrapunova IA, Kostinov MP, Magomedova NA, Link AV, Loktionov MN, Cherdantsev MA, et al. Level of specific immunoglobulin to hepatitis B virus core antigen in groups of health care workers with different risk of parenteral viral hepatitis B infection. Pacific Medical Journal. 2025;(1):51–58. (In Russ.). DOI: https://doi.org/10.34215/1609-1175-2025-1-51-58.
36. Serikova EN, Ostankova YuV, Anufrieva EV, Reingardt DE, Schemelev AN, Zueva EB, et al. Prevalence of parenteral viral hepatitis B and C markers among migrants in the North-West Federal District. HIV Infec tion and Immunosuppressive Disorders. 2024;16(3):94–106. (In Russ.). DOI: https://doi.org/10.22328/2077-9828-2024-16-3-94-106.
37. Polyanina AV, Bystrova TN, Zalesskikh AA. Assessment of population immunity to hepatitis B virus in the population of a large city in the European part of Russia. Public Health and Life Environment. 2019;(12):62– 65. (In Russ.). DOI: https://doi.org/10.35627/2219–5238/2019–321–12–62–65.
38. Bauer T, Jilg W. Hepatitis B surface antigen-specific T and B cell memory in individuals who had lost protective antibodies after hepatitis B vaccination. Vaccine. 2006;24(5):572–577. DOI: https://doi.org/10.1016/j.vaccine.2005.08.058.
39. Grazhdanceva AA, Nosareva OV, Nesterov AE, Sivolobova GF, Lokteva LI, Aleinikov RP, et al. Study of immunity indicators during vaccination against hepatitis B. Epidemiology and Vaccine Prevention. 2008;(5):25– 29. (In Russ.). EDN: https://elibrary.ru/KPZJDH.
40. Lu CY, Ni YH, Chiang BL, Chen PJ, Chang MH, Chang LY, et al. Humoral and cellular immune responses to a hepatitis B vaccine booster 15–18 years after neonatal immunization. The Journal of Infectious Diseases. 2008;97(10):1419–1426. DOI: https://doi.org/10.1086/587695.
41. Valats JC, Tuaillon E, Funakoshi N, Hoa D, Brabet MC, Bolloré K, et al. Investigation of memory B cell responses to hepatitis B surface antigen in health care workers considered as non-responders to vaccination. Vaccine. 2010;28(39):6411–6416. DOI: https://doi.org/10.1016/j.vaccine.2010.07.058.
Review
For citations:
Platonova TA, Sklyar MS, Korotkikh KA, Abakumova AM, Karbovnichaya EA, Shayuk A. Predictive Factors of the Post-Vaccination Immune Response to Viral Hepatitis B in Medical Staff and Prospects for Optimizing Immunoprophylaxis Tactics. Ural Medical Journal. 2026;25(4):7–24. (In Russ.) https://doi.org/10.52420/umj.25.4.7. EDN: HYGPTQ
Views:
66
JATS XML
Email this article 