ORIGINAL RESEARCH article
Front. Public Health
Sec. Occupational Health and Safety
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1657353
This article is part of the Research TopicWorld Hepatitis Day - Advances in Hepatitis Research: Bridging Gaps and Exploring New FrontiersView all 5 articles
Hepatitis A and B immunity and vaccination willingness among special school employees in Rhineland-Palatinate
Provisionally accepted
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
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Abstract Introduction Employees at special schools face elevated risks of hepatitis A and B (HAV/HBV) due to close contact with pupils requiring personal care. Evidence on immunity and vaccination uptake in this occupational group is limited. Methods Data from 1,742 employees at special schools in Rhineland-Palatinate, Germany (2021– 2023), were collected through online anamnesis forms, selected to ensure efficiency and effectiveness, as well as medical evaluations, vaccination records, and anti-HBs testing during mandatory occupational health care. Self-assessed infection risk, HAV/HBV immunity, and vaccination acceptance rates were analyzed using descriptive statistics and logistic regression. Results 74% of the participants (83.5% female; median age: 43.7 years; 33.3% teachers, 62.2% educational specialists, 2.2% trainees, 2.4% others) completed the online anamnesis; 79% reported an increased occupational infection risk. Medical assessments confirmed HAV immunity in 54% and HBV immunity in 59%. Despite this awareness, vaccination gaps persisted: 58% of all employees received a recommendation for HAV and/or HBV vaccination, but only about half accepted it during the occupational health consultation. Younger age was the only significant predictor of vaccine acceptance (aOR 0.968 CI [0.952, 0.985]; p < .001). Discussion Employees at special schools perceive a high risk of infection, yet substantial gaps in HAV and HBV immunity remain. Despite counseling, vaccination uptake was modest, with younger staff more likely to accept. The discrepancy between high perceived risk and low uptake suggests barriers such as vaccine hesitancy, distrust, or convenience factors. Moreover, the mismatch between self-reported and confirmed immunity underscores the importance of systematic medical examinations. Occupational health care offers a key opportunity for targeted pre-employment vaccination and education, particularly for older employees.
Keywords: Special schools, Occupational Medicine, Infection risk, Hepatitis A and B, Vaccination, teachers
Received: 01 Jul 2025; Accepted: 15 Oct 2025.
Copyright: © 2025 Kegel, Goessler, Schmitz, Dietz, Letzel and Diehl. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Peter Kegel, peter.kegel@unimedizin-mainz.de
Elisabeth Diehl, elisabeth.diehl@unimedizin-mainz.de
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