Effectiveness of a hepatitis B vaccination program at two tertiary hemodialysis centers
Bibliographic record
Abstract
INTRODUCTION: Hemodialysis (HD) patients are at increased risk of hepatitis B infection in comparison to the general population. Despite a more intensified hepatitis vaccination regimen, response rates in HD patients are typically low. The study was conducted to quantify response rate to a new hepatitis B vaccination protocol initiated in late 2015, determine risk factors affecting response rate, and assess adherence to protocol. METHODS: This retrospective chart review evaluated all HD patients eligible for hepatitis B vaccination in two large dialysis clinics from initiation of the hepatitis B protocol to July 2017. Recombinant hepatitis vaccine (Recombivax® HB) 40 μg was administered in a 3-dose regimen at months 0, 1, and 6 to patients with hepatitis B surface antibodies (anti-HBs) <10 mIU/mL. A repeat series was given if anti-HBs levels remained below 10 mIU/mL after the first series. A booster dose was given if anti-HBs titers fell below 10 mIU/mL after initial response to a second series vaccination. FINDINGS: Of 411 patients at the two HD centers, 142 patients received hepatitis B vaccination with a total of 168 vaccine courses given, series 1: n = 86, series 2: n = 60 and booster: n = 22. Response rates to vaccination were 61.4%, 58.3%, and 81.8%, respectively. In univariate analysis, adherence to protocol significantly affected response rate (P = 0.035). A multivariate analysis assessing response rates to series 1, 2 or booster confirmed that adherence was a significant risk factor (OR = 2.2; 95% CI 1.4-3.4; P = 0.0005). DISCUSSION: This was the first study to examine adherence to regimen and identified adherence as an important predictor of vaccine response. Adherence is one of the few modifiable risk factors that can be optimized in an effort to improve response to hepatitis B vaccination.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".