{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T17:24:53Z","timestamp":1762795493258,"version":"build-2065373602"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Employees at special schools face elevated risks of hepatitis A and B (HAV\/HBV) due to close contact with pupils requiring personal care. Evidence on immunity and vaccination uptake in this occupational group is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from 1,742 employees at special schools in Rhineland-Palatinate, Germany (2021\u20132023), were collected through online anamnesis forms, selected to ensure efficiency and effectiveness, as well as medical evaluations, vaccination records, and anti-HBs testing during mandatory occupational health care. Self-assessed infection risk, HAV\/HBV immunity, and vaccination acceptance rates were analyzed using descriptive statistics and logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      74% of the participants (83.5% female; median age: 43.7\u202fyears; 33.3% teachers, 62.2% educational specialists, 2.2% trainees, 2.4% others) completed the online anamnesis; 79% reported an increased occupational infection risk. Medical assessments confirmed HAV immunity in 54% and HBV immunity in 59%. Despite this awareness, vaccination gaps persisted: 58% of all employees received a recommendation for HAV and\/or HBV vaccination, but only about half accepted it during the occupational health consultation. Younger age was the only significant predictor of vaccine acceptance (aOR 0.968 CI [0.952, 0.985];\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Employees at special schools perceive a high risk of infection, yet substantial gaps in HAV and HBV immunity remain. Despite counseling, vaccination uptake was modest, with younger staff more likely to accept. The discrepancy between high perceived risk and low uptake suggests barriers such as vaccine hesitancy, distrust, or convenience factors. Moreover, the mismatch between self-reported and confirmed immunity underscores the importance of systematic medical examinations. Occupational health care offers a key opportunity for targeted pre-employment vaccination and education, particularly for older employees.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1657353","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T17:23:06Z","timestamp":1762795386000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hepatitis A and B immunity and vaccination willingness among special school employees in Rhineland-Palatinate"],"prefix":"10.3389","volume":"13","author":[{"given":"Peter","family":"Kegel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"G\u00f6ssler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nico","family":"Schmitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavel","family":"Dietz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Letzel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Diehl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1002\/jmv.24699","article-title":"Seroepidemiology of hepatitis A and B and vaccination status in staff at German schools for the handicapped","volume":"89","author":"Claus","year":"2017","journal-title":"J Med Virol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"20198","DOI":"10.1038\/s41598-022-24579-7","article-title":"Hepatitis A and hepatitis B infection risk among employees at schools for disabled pupils","volume":"12","author":"Lang","year":"2022","journal-title":"Sci Rep"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1023\/A:1026793900057","article-title":"Prevalence of hepatitis B infection in long-stay mentally handicapped adults","volume":"16","author":"Asensio","year":"2000","journal-title":"Eur J Epidemiol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"3190","DOI":"10.1001\/jama.1985.03360220056028","article-title":"Transmission of hepatitis B virus to classroom contacts of mentally retarded carriers","volume":"254","author":"Breuer","year":"1985","journal-title":"JAMA"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1177\/014107689608900712","article-title":"Seroprevalence of hepatitis B and C virus in two institutions caring for mentally handicapped adults","volume":"89","author":"Cramp","year":"1996","journal-title":"J R Soc Med"},{"key":"ref6","year":"2024"},{"key":"ref7","year":"2024"},{"key":"ref8","volume-title":"Verordnung zur arbeitsmedizinischen Vorsorge: ArbMedVV. Stand","year":"2019"},{"key":"ref9","volume-title":"Empfehlungen der St\u00e4ndigen Impfkommission (STIKO) beim Robert Koch-Institut 2024","year":"2025"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"S44","DOI":"10.1016\/0264-410X(95)93546-L","article-title":"Selective risk group strategies in Europe","volume":"13","author":"Jilg","year":"1995","journal-title":"Vaccine"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1007\/s00103-013-1673-x","article-title":"Die Seroepidemiologie der Hepatitis A, B und C in Deutschland: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1)","volume":"56","author":"Poethko-M\u00fcller","year":"2013","journal-title":"Bundesgesundheitsblatt"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1186\/1471-2458-8-132","article-title":"Viral hepatitis in Germany: poor vaccination coverage and little knowledge about transmission in target groups","volume":"8","author":"Schenkel","year":"2008","journal-title":"BMC Public Health"},{"key":"ref13","volume-title":"Empfehlungen der St\u00e4ndigen Impfkommission (STIKO) beim Robert-Koch-Institut","year":"2019"},{"key":"ref14","volume-title":"WHOAction plan for the health sector response to viral hepatitis in the WHO European region","year":"2017"},{"key":"ref15","first-page":"1","article-title":"Immunization of health-care personnel: recommendations of the advisory committee on immunization practices (ACIP)","volume":"60","year":"2011","journal-title":"MMWR Recomm Rep"},{"key":"ref16","first-page":"405","article-title":"Hepatitis B vaccines","volume":"84","year":"2009","journal-title":"Wkly Epidemiol Rec"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1055\/s-2005-870834","article-title":"Was wissen Medizinstudenten \u00fcber ihren Impfstatus und wie ist ihr Impfschutz wirklich?","volume":"130","author":"Wallaschofski","year":"2005","journal-title":"Dtsch Med Wochenschr"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2454","DOI":"10.3390\/v15122454","article-title":"Hepatitis B in healthcare personnel: an update on the global landscape","volume":"15","author":"Nikolopoulou","year":"2023","journal-title":"Viruses"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1657353\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T17:23:07Z","timestamp":1762795387000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1657353\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,10]]},"references-count":18,"alternative-id":["10.3389\/fpubh.2025.1657353"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1657353","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,10]]},"article-number":"1657353"}}