| Sumario: | BACKGROUND: Active immunization is the most important measure for controlling hepatitis B (HB) virus infection. The outcome of HB vaccination has been investigated in only a very small number of cohort studies, some of which found a number of cases of HBV infection. MATERIAL AND METHODS: Using a design different from that of earlier studies, we have investigated the occurrence of HBV infection and clinical HB disease in individuals who had a complete HB vaccination series. Reported cases of HB/HBV infections among 1235 German health care workers (HCW) were analyzed with special regard to the question of whether or not HB vaccination had taken place in the past. RESULTS: 23 persons had undergone a complete vaccination series with complete documentation: 18 were non-responders (post-vaccination anti-HBs < 10 IU/l), one was a low-responder (anti-HBs < 100 IU/l), and four were responders (100 IU/l).While all responders seroconverted without clinical sign of hepatitis, ten non-/low-responders contracted chronic HB/HBV infection and seven contracted self-limiting HB. CONCLUSION: Vaccination should be only regarded as 'successful', if the post-vaccination anti-HBs concentration is at least 100 IU/l.
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