Hepatitis B and admission to medical school

Obligatory occupational health check increases vaccination rates among medical students

In October 2002 an obligatory occupational health check for all preclinical students at the University of Erlangen-Nuremberg was introduced. Over the period 2005 to 2007, medical students started their clinical year either with or without a health check during their preclinical years. The aim of the study was to evaluate the efficacy of health checks for preclinical students with respect to vaccination rates. At the beginning of the clinical year we examined 242 consecutive students, 121 with and 121 without a preceding preclinical occupational health check. The immunisation rate against hepatitis B increased during medical education from 50% to 96% in women and from 58% to 96% in men. In medical students without an initial occupational health check, vaccination rates were significantly lower (85% in women and 81% in men). A significant benefit from the preclinical check was seen in men regarding immunisation status for hepatitis B, tetanus, diphtheria, polio, rubella and mumps and in women for hepatitis B and rubella. This study demonstrates that it is possible to significantly increase vaccination rates, particularly for men. Even in medical students starting their clinical training, an individual occupational health check is necessary to optimise immunisation against infectious diseases. Routine occupational health checks could make an important contribution to closing gaps in vaccination coverage.

Student health policy of a German medical school--results of a cross sectional study concerning students' immunity to vaccine-preventable diseases

Medical students come into contact with infectious materials early in their medical education. Aim of this study was to assess medical students' immunity to vaccine-preventable diseases and to ensure immunity against hepatitis B. An occupational health medical was offered to all medical students with special emphasis on preclinical students. The examination included a check of the certificates of vaccination and serological tests concerning hepatitis B virus, hepatitis C virus and, on request, HIV. A lecture on occupational risks and general precautions was given to the students. In 7 of 804 tested students serological markers of a previous hepatitis B infection were discovered, fortunately none of the students was infectious. No case of infection with the hepatitis C virus (n=804) or HIV (n=700 tested voluntary) was identified. For 52 percent of the students vaccination against hepatitis B was necessary to guarantee protective immunity. Documented protection against other vaccine-preventable diseases as tetanus (71%), diphtheria (67%), poliomyelitis (56%), pertussis (2%), measles (32%), mumps (24%) and rubella (25%) was also insufficient. As a result a vaccination against hepatitis B in childhood without documented response doesn't guarantee a sufficient protection. An occupational health medical at the beginning of preclinical training seems to be an adequate method of making medical students aware of occupational risks, immunization policies and the importance of occupational medicine.