{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:50:39Z","timestamp":1792198239837,"version":"4.4.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Hepatitis B virus infection is a major public health problem in India, and all health-care workers (HCWs) need to be immunized to prevent occupational exposure. This study was done to find the hepatitis B vaccination rates, immune response, and predictors of titer &lt;10 mIU\/ml among students and HCWs of a tertiary care institution in the state of Kerala.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This was a cross-sectional study conducted in the Department of Microbiology, Government TD Medical College, Alappuzha, Kerala, India, for a period of 1\u00bd years between January 1, 2016, and June 30, 2017. Vaccination rates were collected through a screening proforma. Of the 1321 participants who filled the screening proforma, 5 ml of blood was collected aseptically from 579 participants who were fully vaccinated (all the three doses of vaccine) and stored at \u221220\u00b0C until antibody to hepatitis B surface antigen (anti-HBs) assay was done using Microlisa (Biorad). Data were analyzed using SPSS for Windows, version 16.0. (SPSS Inc., Chicago, IL, USA) (trial version).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Statistical Analysis:<\/jats:title>\n                    <jats:p>Descriptive data were expressed using frequencies and percentages, and Chi-square test was applied to find the association between antibody titer &lt;10 mIU\/ml and independent variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the 1321 participants who filled up the screening proforma, the vaccination rate was 72.6%. Majority of the participants, i.e. 83.5% of doctors, 81.1% of nurses, 69.7% of students, and 21.4% of technicians, had taken all the three doses of hepatitis B vaccine. Of the fully vaccinated (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 959) participants, 76.9% had the vaccination during adulthood and only 26.1% had it during childhood. The correlate of protection was defined as the presence of anti-HBs \u226510 mIU\/ml. The mean antibody titer was 448 \u00b1 284.97 mIU\/ml ranging from 9.8 to 2000. Of the 579 participants whose titer was checked, 71 (12.3%) had a nonprotective titer of &lt;10 mIU\/ml. We found that age &gt;35 (odds ratio [OR]: 3.85, 95% confidence interval [CI]: 2.12\u20136.99]), last dose &gt;10 years (OR: 5.01, 95% CI: 2.94\u20138.55), no boosters or revaccination (OR: 2.94, 95% CI: 1.42\u20136.07), and body mass index (BMI) &gt;25 (OR: 2.51, 95% CI: 1.44\u20133.39) were associated with nonprotective titer.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>More than a quarter of the study population who were at high risk of exposure were unvaccinated or partially vaccinated. Even after taking the full course of hepatitis B vaccine, 12.3% had titer &lt;10 mIU\/ml. Nonprotective titer was found to be associated with age &gt;35 years, last dose taken &gt;10 years ago, no boosters\/revaccination, and BMI \u226525.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/picr.picr_119_19","type":"journal-article","created":{"date-parts":[[2020,5,6]],"date-time":"2020-05-06T05:32:56Z","timestamp":1588743176000},"page":"209-215","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Immune response to hepatitis B vaccine"],"prefix":"10.4103","volume":"12","author":[{"given":"Anitha","family":"Madhavan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhanya 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