Hepatitis B Vaccination Evaluation in Community Health Workers

Initially, a virtual invitation was made by the managers of each unit to the active CHWs. Those who showed up at the scheduled date and place and agreed to participate in the study, after signing the Free and Informed Consent Term (FICT), were invited to answer the questionnaire. This questionnarie contained questions about socio-demographic characteristics and knowledge about hepatitis B vaccination. After this step, the vaccination card was requested to check the hepatitis B vaccination record; in its absence, information was sought in the National Immunization Program Information System (NIPIS).
Finally, 8 milliliters (mL) of blood sample were collected through venipuncture in the upper limb for hepatitis B serology. All samples were tested for the following serological markers: hepatitis B surface antigen (HBsAg), antibodies to hepatitis B virus core protein (anti-HBc) and anti-HBs. Rapid Test from Bioclin, Brazil, was used for detecting HBsAg marker. The anti-HBc and anti-HBs markers were tested using the chemiluminescence method (Architect i1000TM, Abbott Diagnostics).
The test results were personally delivered to each CHW. Those who were not vaccinated or had an incomplete schedule were oriented to take a new three-dose schedule or to complete the schedule^12,16.
Subjects eligible for phase II received one dose of hepatitis B vaccine (“challenge dose”), conceptualized as administration of one dose of hepatitis B vaccine to screen for the presence of memory antibodies against possible exposure to the virus²⁴. Thus, within 30 to 60 days after vaccination, a new blood sample was collected for serological testing for the anti-HBs marker. The test was performed using the electrochemiluminescence method (Cobas e 411TM, Elecsys Anti-HBs kit, Roche). Individuals who did not present protective anti-HBs titers were referred to the public health care network and oriented to continue hepatitis B vaccination.