Where does Switzerland stand regarding the vaccination of high-risk individuals?

Author: Dr. Virginie Masserey Spicher

Updated: 10 / 2007

Answer:

The recommendations for hepatitis B vaccinations are based on 3 approaches:

  • Individual vaccinations of high-risk persons (e.g. medical personnel, intravenous drug users, persons with multiple sexual partners, etc.);
  • Screening of pregnant women for HBsAg, with vaccination of the newborn in case of positive results;
  • Universal vaccination of all adolescents (in Switzerland, 11-15 years old).

The basic difference between individual vaccination of high-risk persons and universal vaccination is that with individual vaccination, a serological control of successful vaccination should be conducted 1 month after the third vaccine injection, whereas a control is not carried out in the case of universal vaccination. In case of universal vaccination a serological pre-determination is not conducted, whereas, in the case of vaccination of persons at risk, the pre-examination (for anti-HBc) is discriminating. As a rule, medical staff are not pre-tested (only a small proportion show clear signs of an HBV infection), whereas this can be justified in intravenous drug users, for example (a substantial number already have signs of florid or previous HBV infection). The recommendations applicable to Switzerland originate from the following documents:

BAG: Recommendations for Hepatitis B vaccination. Supplement II (Situation December 1997) BAG File “Infectious Diseases: Diagnosis and Combat”
http://www.bag.admin.ch/infekt/publ/supplementa/d/suppl2_hepb.pdf

BAG/SKIF/SEVHEP: Recommendations for Hepatitis B vaccination: Situation December 1997. BAG Bulletin 1998: 5:4-5

Recommendations for Hepatitis B vaccination: Additions to Supplement II of Dec. 1997. BAG Bulletin 1998; 36: 4-5.

Analysis of the economic aspect of alternative Hepatitis B vaccination strategies in Switzerland. BAG Bulletin 1998; 4:3-6.

References:

Reichen J et al. Hepatitis B Virusinfektion: Diagnose, klinische Folgen, Therapie und Prophylaxe. PRAXIS 2002;91:307-319.

Allgemeine Empfehlungen zu Impfungen. Stand Juni 2003. Supplementum XVI zum blauen Ordner Infektionskrankheiten. Empfehlungen des Bundesamtes für Gesundheit (BAG) und der Schweizerischen Kommission für Impffragen (SKIF): 1-24.

Empfehlungen zur Hepatitis-B-Impfung. Bull BAG 1998;36:4-5.