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O'Brien SF, Goldman M, Ehsani-Moghaddam B, Fan W, Osmond L, Pambrun C, Drews SJ. SARS-CoV-2 vaccination in Canadian blood donors: Insight into donor representativeness of the general population. Vaccine X 2024; 18:100498. [PMID: 38800670 PMCID: PMC11127215 DOI: 10.1016/j.jvacx.2024.100498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 05/10/2024] [Accepted: 05/11/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction Blood donors world-wide were indispensable for monitoring anti-SARS-CoV-2 antibodies generated by infection and vaccination during the pandemic. Prior to the pandemic, donor vaccination behaviours were under-studied. We aimed to compare the percentage of Canadian blood donors with SARS-CoV-2 vaccination antibodies with the percentage of the general population who received at least one dose of vaccine each month during initial vaccine deployment. We also report donor attitudes towards SARS-CoV-2 vaccination. Methods Canadian blood donors were randomly selected for SARS-CoV-2 antibody testing over 2021 (N = 165,240). The percentage of donor samples with vaccination antibodies were compared with the percentage of general population who received at least one dose of vaccine in each month of 2021 except February. A random sample of Canadian blood donors were surveyed about vaccination intent and attitudes (N = 4,558 participated, 30.4 % response rate). Results The percentages of the general population vaccinated and donors with vaccination antibodies increased from 1 % to over 90 %. General population vaccination was greater early in vaccine deployment than donors (p < 0.05), greater in donors than the general population by mid-2021 (p < 0.05) but they were similar by the end of 2021. While 52.6 % of surveyed donors had received vaccine in May 2021, a further 41.1 % intended to when eligible. Most donors thought COVID-19 infection could be serious (83.5 %) and that it was important to be vaccinated even if previously infected (77.8 %). Conclusion Early pandemic vaccine prioritization to at-risk individuals and healthcare workers gave rise to higher general population vaccination percentages, while donors had higher vaccine antibody percentages as vaccine was deployed to progressively younger age groups. Since blood donors may be more willing to receive vaccination, under pandemic conditions they may be valuable for monitoring vaccination-induced seroprevalence.
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Affiliation(s)
- Sheila F. O'Brien
- Epidemiology & Surveillance, Canadian Blood Services, 1800 Alta Vista Drive, Ottawa, Ontario K1G 4J5, Canada
- School of Epidemiology & Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario K1G 5Z3, Canada
| | - Mindy Goldman
- Donation and Policy Studies, Canadian Blood Services, 1800 Alta Vista Drive, Ottawa, Ontario K1G 4J5, Canada
- Department of Pathology & Laboratory Medicine, Faculty of Medicine, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario K1G 5Z3, Canada
| | - Behrouz Ehsani-Moghaddam
- Epidemiology & Surveillance, Canadian Blood Services, 1800 Alta Vista Drive, Ottawa, Ontario K1G 4J5, Canada
- Centre for Studies in Primary Care, Department of Family Medicine, Queens University, 220 Bagot Street, Kingston, Ontario K7L 3G2, Canada
| | - Wenli Fan
- Epidemiology & Surveillance, Canadian Blood Services, 1800 Alta Vista Drive, Ottawa, Ontario K1G 4J5, Canada
| | - Lori Osmond
- Epidemiology & Surveillance, Canadian Blood Services, 1800 Alta Vista Drive, Ottawa, Ontario K1G 4J5, Canada
| | - Chantale Pambrun
- Innovation & Portfolio Management, Medical Affairs & Innovation, Canadian Blood Services, 1800 Alta Vista Drive, Ottawa, Ontario K1G 4J5, Canada
| | - Steven J. Drews
- Microbiology, Canadian Blood Services, 8249-114 Street, Edmonton, Alberta T6G 2R8, Canada
- Department of Laboratory Medicine & Pathology, Faculty of Medicine & Dentistry, University of Alberta, 118 Street & 86 Avenue, Edmonton, Alberta T6G 2R3, Canada
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Jentsch U, Vermeulen M, van den Berg K, Swanevelder R, Creel D, Jacobs G, Hemingway-Foday JJ, Nyoni C, Murphy EL, Custer B. A case-control study of risk factors for incident hepatitis B virus infection in South African blood donors. Int J Infect Dis 2024; 141:106958. [PMID: 38373648 PMCID: PMC11034725 DOI: 10.1016/j.ijid.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/19/2024] [Accepted: 02/01/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES Hepatitis B virus (HBV) infection remains a global health problem. Risk factors for HBV infection are usually assessed in prevalent rather than incident infections. To identify demographic and behavioral risks associated with incident HBV among South African blood donors. METHODS A case-control study was performed between November 2014 and January 2018. Cases were blood donors testing positive for HBV DNA with or without hepatitis B surface antigen but negative for antibody to hepatitis B core antigen. Participants completed an audio computer-assisted structured interview on exposures during the previous 6 months. Sex-specific multivariable logistic regression yielded independent associations between risks and HBV infection. RESULTS 56 females and 37 males with incident HBV were compared to 438 female and 439 male controls, respectively. For females, risk factors were accepting money or goods for sex, using agents to prepare one's anus prior to anal sex, penetrating injury, non-Black race, and lower educational status. Men reporting homosexual or bisexual orientation or sex with other men, previous injury, referral for HBV testing, or lack of medical insurance were at increased risk. For both sexes, having more than two male sexual partners increased risk. CONCLUSIONS Sexual behaviors predominated over parenteral exposures as risks for incident HBV in both female and male blood donors.
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Affiliation(s)
- Ute Jentsch
- The South African National Blood Service, Johannesburg, South Africa.
| | - Marion Vermeulen
- The South African National Blood Service, Johannesburg, South Africa; University of the Free State, Bloemfontein, South Africa
| | - Karin van den Berg
- The South African National Blood Service, Johannesburg, South Africa; University of the Free State, Bloemfontein, South Africa
| | - Ronél Swanevelder
- The South African National Blood Service, Johannesburg, South Africa
| | | | - Genevieve Jacobs
- The South African National Blood Service, Johannesburg, South Africa
| | | | - Cynthia Nyoni
- The South African National Blood Service, Johannesburg, South Africa
| | - Edward L Murphy
- University of California San Francisco, San Francisco, USA; Vitalant Research Institute, San Francisco, USA
| | - Brian Custer
- Vitalant Research Institute, San Francisco, USA; University of California San Francisco, San Francisco, USA
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O'Brien SF, Ehsani-Moghaddam B, Goldman M, Drews SJ. Prevalence of Hepatitis B in Canadian First-Time Blood Donors: Association with Social Determinants of Health. Viruses 2024; 16:117. [PMID: 38257817 DOI: 10.3390/v16010117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Hepatitis B is transmitted sexually, by blood contact, and vertically from mother to child. Chronic hepatitis B is often seen in immigrants from higher-prevalence countries and their Canadian-born children. We assessed the relationship between hepatitis B and social determinants of health. Included were 1,539,869 first-time Canadian blood donors from April 2005 to December 2022. All donations were tested for hepatitis B markers. Logistic regression was fit with chronic hepatitis B as the dependent variable and age, sex, year, and ethnocultural composition and material deprivation quintiles as independent variables. Chronic hepatitis B prevalence was 47.5/100,000 (95% CI 41.5-53.5, years 2017-2022). Chronic hepatitis B prevalence was elevated in males, older age groups, and those living in more materially deprived and higher ethnocultural neighbourhoods. Of 212,518 donors from 2020 to 2022 with race/ethnicity data, chronic hepatitis B prevalence was highest in East Asians. The findings are consistent with infections in immigrants, acquired in their country of origin, in their Canadian-born children and in those with other risks. As blood donors are a low-risk population unaware of their infection and unlikely to seek testing, our results highlight the ongoing public health challenges of diagnosing chronic hepatitis B and treating it when appropriate.
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Affiliation(s)
- Sheila F O'Brien
- Epidemiology & Surveillance, Canadian Blood Services, Ottawa, ON K1G 4J5, Canada
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, ON K1G 192, Canada
| | - Behrouz Ehsani-Moghaddam
- Epidemiology & Surveillance, Canadian Blood Services, Ottawa, ON K1G 4J5, Canada
- Centre for Studies in Primary Care, Department of Family Medicine, Queens University, Kingston, ON K7L 3N6, Canada
| | - Mindy Goldman
- Donation and Policy Studies, Canadian Blood Services, Ottawa, ON K1G 4J5, Canada
- Department of Pathology & Laboratory Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 192, Canada
| | - Steven J Drews
- Microbiology, Canadian Blood Services, Edmonton, AB T6G 2R8, Canada
- Department of Laboratory Medicine & Pathology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2E1, Canada
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Damiani AS, Holzmayer V, Galli C, De Nuzzo M, Anderson M, Cloherty G, Di Renzo N. Serological and Molecular Characterization of Occult HBV Infection in Blood Donors from South Italy. Viruses 2023; 16:71. [PMID: 38257771 PMCID: PMC10819115 DOI: 10.3390/v16010071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024] Open
Abstract
Despite good vaccine coverage and careful blood donor selection policies, hepatitis B virus (HBV) is still the most frequent viral infection among blood donors (BDs) in Italy, mostly in the occult form (OBI). We studied the virological features of OBI in BDs from South Italy by serology, molecular testing for HBV-DNA, and sequencing for HBV genotypes and mutations. One hundred and two samples from 95 BDs (22.1% first time, 87.9% regular, median age 57 years) positive for HBV-DNA and negative for HBsAg were retrospectively analyzed. HBV biomarkers were detected in 96.9% (anti-HBc in 44.2%, anti-HBc plus anti-HBs in 49.5%, anti-HBs alone in 3.2%). No risk factor was declared by 45.3% of donors. HBV-DNA levels were very low (median: 7 IU/mL). All samples harbored HBV genotype D and single or multiple mutations in the S gene were found in 28/36 sequences analyzed and in 75% of donors. Mutations were unrelated to gender, donor group or serological patterns. An HBsAg assay with enhanced sensitivity was positive in samples from seven donors (7.4%), two of which negative for HBV-DNA by real-time PCR. OBI still represents a risk for HBV transmission from blood donations; screening by highly sensitive serological and molecular assays is warranted.
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Affiliation(s)
| | - Vera Holzmayer
- R&D, Abbott Diagnostics, Chicago, IL 60064, USA; (V.H.); (M.A.); (G.C.)
| | | | - Mariangela De Nuzzo
- Servizio Immunotrasfusionale, A.O. Vito Fazzi, 73100 Lecce, Italy; (M.D.N.); (N.D.R.)
| | - Mark Anderson
- R&D, Abbott Diagnostics, Chicago, IL 60064, USA; (V.H.); (M.A.); (G.C.)
| | - Gavin Cloherty
- R&D, Abbott Diagnostics, Chicago, IL 60064, USA; (V.H.); (M.A.); (G.C.)
| | - Nicola Di Renzo
- Servizio Immunotrasfusionale, A.O. Vito Fazzi, 73100 Lecce, Italy; (M.D.N.); (N.D.R.)
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da Cunha Rosa LR, Brandão LGVA, Moura WÉA, Campos LR, Pessoni GC, de Oliveira Roque E Lima J, de Moraes JC, Dos Santos Carneiro MA, Teles SA, Caetano KAA. Prevalence, Risk Factors and Vaccine Response against Hepatitis B in People Aged 50 Years or Older. Vaccines (Basel) 2023; 11:vaccines11030597. [PMID: 36992181 DOI: 10.3390/vaccines11030597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/26/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
Universal immunization against hepatitis B has contributed to reducing incidence of the disease, but older individuals remain susceptible to acquiring the hepatitis B virus worldwide. Thus, this study aimed to investigate the epidemiology of HBV infection in individuals aged 50 years and over in central Brazil and to evaluate the immunogenicity of the monovalent vaccine against hepatitis B in this age group using two vaccine regimens. Method: Initially, a cross-sectional and analytical study was carried out to investigate the epidemiology of hepatitis B. Then, individuals without proof of vaccination for hepatitis B were recruited for a phase IV randomized and controlled clinical trial using two vaccine regimens: Intervention Regimen (IR) (three doses of 40 μg at months 0, 1 and 6) vs. Comparison Regimen (CR) (three doses of 20 μg at months 0, 1 and 6). Results: The overall prevalence of exposure to HBV was 16.6% (95% CI: 14.0%–9.5%). In the clinical trial, statistical differences in protective titers were observed (p = 0.007; IR 96% vs. CR 86%) and the geometric mean of anti-HBs titers was higher in individuals who received the IR (518.2 mIU/mL vs. 260.2 mIU/mL). In addition, the proportion of high responders was higher among those who received the IR (65.3%). Conclusion: reinforced doses should be used in individuals aged 50 years or older to overcome the lower efficacy of the vaccine against hepatitis B.
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Affiliation(s)
| | | | | | - Lays Rosa Campos
- Faculty of Nursing, Federal University of Goias, Goiânia 74605-080, GO, Brazil
| | | | | | - José Cássio de Moraes
- Faculty of Medical Sciences of Santa Casa de São Paulo, São Paulo 01224-001, SP, Brazil
| | | | - Sheila Araújo Teles
- Faculty of Nursing, Federal University of Goias, Goiânia 74605-080, GO, Brazil
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O’Brien SF, Reedman CN, Osiowy C, Bolotin S, Yi QL, Lourenço L, Lewin A, Binka M, Caffrey N, Drews SJ. Hepatitis B Blood Donor Screening Data: An Under-Recognized Resource for Canadian Public Health Surveillance. Viruses 2023; 15:v15020409. [PMID: 36851623 PMCID: PMC9966614 DOI: 10.3390/v15020409] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/24/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Hepatitis B surveillance is essential to achieving Canada's goal of eliminating hepatitis B by 2030. Hepatitis B rates, association of infection with vaccine age-eligibility, and risk factors were analyzed among 1,401,603 first-time Canadian blood donors from 2005 to 2020. Donors were classified as having likely chronic or likely resolved/occult infections based on hepatitis B surface antigen, anti-hepatitis B core antigen, and hepatitis B nucleic acid test results. Likely chronically infected and control donors (ratio 1:4) participated in risk-factor interviews. The 2019 rate of likely chronic infection was 61.9 per 100,000 (95% CI 46.5-80.86) and 1449.5 per 100,000 for likely resolved/occult infections (95% CI 1370.7-1531.7). Likely chronic infections were higher in males (OR 3.2; 95% CI 2.7-3.7) and the vaccine-ineligible birth cohort (OR 1.9; 95% CI 1.6-2.2). The main risk factors were living with someone who had hepatitis (OR 12.5; 95% CI 5.2-30.0) and ethnic origin from a high-prevalence country (OR 8.4; 95% CI 5.9-11.9). Undiagnosed chronic hepatitis B may be more prevalent in Canada than currently determined by traditional passive hepatitis B reporting. Blood donor data can be useful in informing hepatitis B rates and evaluating vaccination programs in Canada.
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Affiliation(s)
- Sheila F. O’Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, ON K1G 4J5, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Correspondence: ; Tel.: +1-613-739-2144
| | - Cassandra N. Reedman
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, ON K1G 4J5, Canada
- Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada
| | - Carla Osiowy
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E 3P6, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Shelly Bolotin
- Center for Vaccine Preventable Disease, University of Toronto, Toronto, ON M5S, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S, Canada
- Public Health Ontario, Toronto, ON M5G 1V2, Canada
| | - Qi-Long Yi
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, ON K1G 4J5, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | | | - Antoine Lewin
- Héma-Québec, Montreal, QC H4R 2W7, Canada
- Faculty of Medicine & Health Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
| | - Mawuena Binka
- BC Centre for Disease Control, Vancouver, BC V5Z 4R4, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Niamh Caffrey
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, ON K1G 4J5, Canada
| | - Steven J. Drews
- Medical Microbiology Department, Canadian Blood Services, Edmonton, AB T6G 2R3, Canada
- Department of Laboratory Medicine & Pathology, Division of Diagnostic and Applied Microbiology, University of Alberta, Edmonton, AB T6G 2R3, Canada
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