Are healthcare workers protected? Evaluation of measles and hepatitis B immunity in small Victorian healthcare facilities.

Ms Alex Hoskins1, Associate Professor Noleen Bennett1, Ms Sandra  Johnson1, Dr Michael Malloy1, Dr Nabeel Imam1, Dr Ann Bull1, Associate Professor Leon Worth1

1Victorian Healthcare Associated Infection Surveillance (VICNISS) Coordinating Centre, Melbourne, Australia


To ensure the safety of patients and healthcare workers (HCWs), national recommendations are for HCWs to have access to vaccines and serological testing to assure protection against vaccine-preventable diseases (VPDs). We sought to determine measles and hepatitis B immunity status of HCWs in small Victorian public healthcare facilities, and to evaluate program differences according to hospital size or location.


Healthcare facilities were required to participate in a point prevalence survey of HCW hepatitis B immunity status in 2016 – 2017 and HCW measles immunity status in 2017-2018. NHMRC-defined staff categories were used for HCW classification: Category A staff were reviewed for hepatitis B immune status, and Categories A,  B and C were reviewed for measles immune status.


A total of 51 healthcare facilities reported HCW hepatitis B immunity, corresponding to a total of 6,633 HCWs. Of these, median facility evidence of immunity was 59.5%, with 11.1% reporting unknown status. A total of 75 healthcare facilities reported HCW measles immunity, corresponding to a total of 17,522 HCWs. Of these, median facility evidence of immunity was 66.7%, with 26.1% unknown. Confirmation of measles immunity was highest in hospitals with largest workforce (>200-500 and >500 HCW).


Despite availability of national guidelines for vaccination of HCWs, implementation remains a challenge. Enhanced and strengthened HCW measles immunisation programs must be prioritised in smaller facilities (<200 staff). Both Hepatitis B and Measles immunity programs must focus upon documentation of status, as well as screening of both existing and new employees.


Alex Hoskins has been working in Infection Prevention and Control since 2003, working in both the public and private health sector.  Her post graduate qualifications include a Master of Nursing (Perioperative); Infection Control Graduate Certificate, Post Graduate Diploma in Education and she is an Accredited Nurse Immuniser. Alex has been a member of the VICNISS Team since January 2015 where she helps coordinate the small Victorian Public Hospital surveillance program.  Alex has a keen interest health care worker immunisation, surveillance and infection prevention and control education.

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