Open Access Open Badges Research article

Associated factors for recommending HBV vaccination to children among Georgian health care workers

Maia Butsashvili1*, George Kamkamidze2, Marina Topuridze1, Dale Morse3, Wayne Triner4, Jack DeHovitz5, Kenrad Nelson6 and Louise-Anne McNutt7

Author affiliations

1 National Center for Disease Control and Public Health (NCDC), 9 Asatiani st., Tbilisi, 0177, Georgia

2 Maternal and Child Care Union, Tbilisi, Georgia

3 Division of Foodborne, Waterborne and Environmental Diseases at CDC, Atlanta, GA, USA

4 Department of Emergency Medicine, at Albany Medical College, Albany, NY, USA

5 Department of Medicine, AT SUNY-Downstate Medical Center, Brooklyn, NY, USA

6 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

7 University at Albany, School of Public Health, Rensselaer, NY, USA

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Citation and License

BMC Infectious Diseases 2012, 12:362  doi:10.1186/1471-2334-12-362

Published: 20 December 2012



Most cases of hepatitis B virus (HBV) infection and subsequent liver diseases can be prevented with universal newborn HBV vaccination. The attitudes of health care workers about HBV vaccination and their willingness to recommend vaccine have been shown to impact HBV vaccination coverage and the prevention of vertical transmission of HBV. The purpose of this study was to ascertain the factors associated with health care worker recommendations regarding newborn HBV vaccination.


A cross-sectional study of prevalence and awareness of hepatitis B and hepatitis B vaccine was conducted among randomly selected physicians and nurses employed in seven hospitals in Georgia in 2006 and 2007. Self-administered questionnaires included a module on recommendations for HBV, HCV and HIV.


Of the 1328 participants included in this analysis, 36% reported recommending against hepatitis B vaccination for children, including 33% of paediatricians. Among the 70.6% who provided a reason for not recommending HBV vaccine, the most common concern was an adverse vaccine event. Unvaccinated physicians and nurses were more likely to recommend against HBV vaccine (40.4% vs 11.4%, PR 3.54; 95% CI: 2.38, 5.29). Additionally, health care worker age was inversely correlated with recommendations for HBV vaccine with older workers less likely to recommend it.


Vaccinating health care workers against HBV may provide a dual benefit by boosting occupational safety as well as strengthening universal coverage programs for newborns.

Hepatitis B; Vaccine; Safety; Health Care Worker; Newborns