Self-reported Hepatitis 'A' immunisation amongst child care workers in the Bundaberg Region

This study carries forward the exploration of the need for additional initiatives to enhance vaccination uptake against hepatitis A infection in child care workers in the Bundaberg region. The purpose of this quantitative study was to identify the self reported hepatitis A immunisation levels amongst workers in long day care (LDC) centres. The study set out to evaluate by survey, the awareness levels of National Health and Medical Research Council (NHMRC) recommendations for hepatitis A immunisation of workers, compare reported hepatitis A levels with self reported hepatitis B immunisation levels and centre practices in relation to policy, record keeping and centre director and worker risk perception. The study was conducted as a confidential postal survey between July and September 1999, by purposive sampling with questionnaires of 163 workers and 15 centre directors. Although a majority believed their occupational situation placed them at increased risk, only 34.3% of workers were immunised against hepatitis A. Changing nappies of children on a weekly basis was reported by 72.4%. While twice as many for hepatitis B than hepatitis A, only half had subsequently undertaken serological testing to confirm hepatitis B post-vaccination immunity. Most workers perceived their occupation placed them at increased risk of infection and were aware of NHMRC recommendations for immunisation, but failed to translate this to vaccination uptake against hepatitis A. Only one centre reported a policy for staff immunisation, while 93% had policies for children. Record keeping was reportedly inconsistent across surveyed centres, with irregular updating and identified a need for further policy and educational and training initiatives for improvements at regional LDC centres. Findings confirm a lack of awareness of NHMRC recommendations. The study suggests a continuing misconception of greater risk of hepatitis B than hepatitis A. Approximately 25% of surveyed workers were in favour of either free immunisation or some form of government or employer subsidised immunisation program for child care staff. This dissertation established a set of regional data on current hepatitis A awareness and self reported immunisation levels in LDC centres.