Immunization status of students of Nishtar medical university against hepatitis B

Dilawar Khan, Hassan Abdullah Shakeel, Hamza Maqsood, Hafiz Muhammad Ahmar Aziz, Muhammad Jahantab Qazi, Syed Asfand Yar Shah


Background: Hepatitis B virus (HBV) infection causes significant morbidity and mortality worldwide. Occupational exposure of health care workers and medical students increase their risk of acquiring HBV infection, and many authorities recommend vaccination. However, significant proportions of health care workers do not receive HBV immunization, and remain at increased risk to HBV infection. The present study was conducted on medical students to evaluate their knowledge regarding HBV and to know their vaccination status.

Methods: This cross sectional, randomized, observational study was done at Nishtar medical university, Multan from November 2017 to July 2018. A pre-structured and tested questionnaire was given to 150 medical students from first year to final year. Out of these students 75 were males and 75 were females. The students were also interviewed about age, gender, year of study, screening before vaccination, history of vaccination, completion of all 3 doses and reasons for not getting vaccinated.

Results: Out of 150 participants, 117 (78%) were vaccinated against HBV. In the vaccinated group, 90 (77%) completed all the three doses of their vaccination schedule and remaining 27 (23%) students were incompletely vaccinated. Rate of vaccine uptake was higher in females; 63 (84%) than in males: 53 (71%). Reasons of not being vaccinated were lack of knowledge about consequences (15.5%), casual behaviour (36%), not knowing from where to get vaccine (12%), fear of injection (10%), busy in studies (10%) and financial problems (8%). Prior screening was done in 74 (63%) students before the vaccination.

Conclusions: Despite the availability and accessibility of a cost-effective hepatitis B vaccine since mid80's, the vaccination coverage among medical students is low. Health education needs to be improved in all medical students. The orientation and awareness programmes should be held to create awareness regarding HBV infection.


Cost effective, Hepatitis B, Medical students, Vaccination, Vaccine

Full Text:



Pourhassan A. Association between ABO Blood/Rhesus grouping and hepatitis B and C: a case-control study. Pak J Biol Sci. 2014 Jun;17(6):868-71.

Purcell RH. The discovery of the hepatitis viruses. Gastroenterol. 1993 Apr 1;104(4):955-63.

El–Serag HB, Rudolph KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterol. 2007 Jun 1;132(7):2557-76.

Shepard CW, Simard EP, Finelli L, Fiore AE, Bell BP. Hepatitis B virus infection: epidemiology and vaccination. Epidemiol Rev. 2006 Jun 5;28(1):112-25.

Centres for Disease Control and Prevention. US Department of Health and Human Services, Public Health Service: Health Information for International Travel 2008. Atlanta. 2007.

Prüss‐Üstün A, Rapiti E, Hutin Y. Estimation of the global burden of disease attributable to contaminated sharps injuries among health‐care workers. Am J Ind Med. 2005 Dec;48(6):482-90.

Gerberding JL. Incidence and prevalence of human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and cytomegalovirus among health care personnel at risk for blood exposure: final report from a longitudinal study. J Infectious Dis. 1994 Dec 1;170(6):1410-7.

Ibrahim N, Idris A. Hepatitis B awareness among medical students and their vaccination status at Syrian Private University. Hepatitis research and treatment. 2014;2014.

Sepkowitz KA. Occupationally acquired infections in health care workers: part II. Ann Internal Med. 1996 Dec 1;125(11):917-28.

Centres for Disease Control and Prevention (1996) Immunization of adolescents: recommendation of the advisory committee on immunization practices, American Academy of Pediatrics, American Family Physicians and American Medical Association. Morbidity and Mortality Weekly Report. 1996;45:1-14.

Chen HL, Chang MH, Ni YH, Hsu HY, Lee PL, Lee CY, et al. Seroepidemiology of hepatitis B virus infection in children: ten years of mass vaccination in Taiwan. JAMA. 1996 Sep 18;276(11):906-8.

La Torre G, Nicolotti N, De Waure C, Chiaradia G, Specchia ML, Mannocci A, et al. An assessment of the effect of hepatitis B vaccine in decreasing the amount of hepatitis B disease in Italy. Virol J. 2008 Dec;5(1):84.

Payton CD, Scarisbrick DA, Sikotra S, Flower AJ. Vaccination against hepatitis B: comparison of intradermal and intramuscular administration of plasma derived and recombinant vaccines. Epidemiol Infection. 1993 Feb;110(1):177-80.

Ginsberg GM, Shouval D. Cost-benefit analysis of a nationwide neonatal inoculation programme against hepatitis B in an area of intermediate endemicity. J Epidemiol Community Health. 1992 Dec 1;46(6):587-94.