Surgery, AIDS, and Hepatitis B

To the Editor. —While the article by Panlilio et al 1 and editorial by Drs Gerberding and Schecter 2 represent positive contributions to the issue of health care professional safety, especially in recognizing the need to increase the scope of barrier precautions, both neglected to mention an important weapon in the battle to reduce the risk of hepatitis B infection. That weapon is immunization. The need for greater barrier precautions is indisputable; however, the best defense against hepatitis B infection is still vaccination. The Centers for Disease Control has long recommended immunization of health care workers, and reported hepatitis B cases among this group decreased 75% between 1982 and 1988, due in large part to immunization efforts, as well as greater implementation of universal blood precautions. 3 Despite the recommendations of the Centers for Disease Control, however, about 60% of high-risk health care workers in the United States remain unvaccinated. 4