Highlights
What are the main findings?
- Among the respondents, 22.7% reported completion of the three-dose hepatitis B vaccination series, with a marked difference between dentists (38.2%) and dental staff (6.3%).
- Hepatitis-related educational exposure, HBV/HCV testing history, and reported workplace vaccination policies were associated with hepatitis B vaccine uptake in exploratory unadjusted analyses.
What are the implications of the main findings?
- The findings suggest room for improvement in hepatitis B vaccination practices among dental healthcare workers and highlight the importance of continued attention to occupational vaccination and infection-control awareness.
- Further studies with larger, representative samples and objectively verified vaccination and immunity status are needed to clarify factors independently associated with vaccine uptake.
Abstract
Background/Objectives: Dental healthcare workers (DHWs) are at high risk of hepatitis B virus (HBV) infection due to occupational exposure. Although hepatitis B (HB) vaccination is recommended in Japan, vaccination coverage and factors associated with vaccine uptake remain unclear. This study aimed to clarify HB vaccination coverage, identify factors associated with vaccine uptake, and explore reasons for non-vaccination among DHWs in Shimonoseki, Japan. Methods: A cross-sectional web-based survey was conducted among 470 DHWs affiliated with the Shimonoseki Dental Association. Data on demographics, HBV/hepatitis C virus (HCV) testing, needlestick injuries, vaccination status, and reasons for non-vaccination were collected. Exploratory unadjusted group differences were analyzed using Chi-square or Fisher’s exact tests. Results: Of the 470 DHWs invited, 66 participated (response rate, 14.0%). Among respondents, 50.0% had a history of HB vaccination; however, only 22.7% had completed the three-dose series. Completion was significantly lower among dental staff than dentists (6.3% vs. 38.2%; p = 0.0025). Vaccination was associated with HBV-related education (p < 0.001), HBV/HCV testing history (HBV p < 0.001; HCV p < 0.001), and institutional policies (p = 0.0363), but not with needlestick injuries. Among the 27 unvaccinated respondents, the most frequently reported reason for non-vaccination was lack of personal recommendation. Conclusions: Among respondents, self-reported three-dose HB vaccination completion was low, particularly among dental staff. Vaccination status was associated with educational exposure, previous HBV/HCV testing, and reported workplace vaccination policies, whereas no association with self-reported needlestick injury history was observed.
1. Introduction
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections remain major causes of liver cancer in Japan, where liver cancer was estimated to cause approximately 26,000 deaths in 2022 [1]. Regional disparities exist in liver cancer mortality rates in Japan, with higher rates reported in western regions [2]. Given this epidemiological context, preventing hepatitis virus infections is considered a critical issue in regional healthcare.
In Japan, hepatitis B (HB) vaccination was introduced in 1986 as part of the national mother-to-child transmission prevention program for infants born to hepatitis B surface antigen (HBsAg)-positive mothers [3,4]. Universal routine HB vaccination for infants younger than one year of age was introduced in October 2016 [4]. Therefore, most currently practicing adult dental healthcare workers (DHWs) were not covered by the national routine HB vaccination program, and HB vaccination for occupational protection among these adults has generally been undertaken outside this program. Occupational HB vaccination remains important for DHWs who may be exposed to blood and body fluids in dental practice.
DHWs are considered a high-risk occupational group for HBV/HCV infection because they are routinely exposed to patients’ blood and saliva during clinical procedures. The Vaccination Guidelines for Healthcare Workers issued by the Japanese Society for Infection Prevention and Control clearly recommend HB vaccine with confirmation of serological immunity for DHWs [5]. Nevertheless, HB vaccine coverage among DHWs in Japan appears to be suboptimal [6,7,8]. Beyond the occupational risk of blood-borne infections such as HBV, systemic viral infections may also have clinically relevant oral manifestations and complications, further highlighting the importance of infection awareness and preventive strategies in dental practice [9,10].
A recent survey in our previous study of 1395 DHWs in Oita Prefecture showed HB vaccine coverage of only 59.1%, with a significantly lower rate among dental staff compared to dentists (54.0% vs. 73.6%; p < 0.001) [8]. In addition, among unvaccinated individuals, positivity rates for HBs antigen and antibody increased with age (HBs antigen positivity reached 3.8% in those in their 70s, while HBs antibody positivity rose to 40.4% in individuals in their 70s and 66.7% in those in their 80s) [8].
Similarly, a study of DHWs in Fukuoka Prefecture reported an HBV infection rate of 12.1% and an HB vaccine coverage rate of 48.2%; additionally, 25.4% of unvaccinated individuals were infected with HBV [6]. Another survey from Oita Prefecture found that HBV/HCV infection rates among DHWs were higher than those among general blood donors [11], with 62% having experienced needlestick or sharps injuries [7], while HB vaccine coverage remained insufficient [7,8]. Suboptimal HB vaccination coverage has also been reported among healthcare workers internationally. A recent systematic review and meta-analysis of nurses from 30 countries reported a pooled complete HB vaccination coverage of 44.8% and identified structural barriers, including vaccine availability and financial costs, as important factors associated with incomplete vaccination [12].
Taken together, these findings suggest that HB vaccine uptake among DHWs in Japan does not meet the levels recommended in current guidelines. However, few studies have systematically evaluated factors associated with HB vaccination uptake or reasons for non-vaccination among DHWs in Japan.
Therefore, this study aimed to determine self-reported hepatitis B vaccination coverage among DHWs in Shimonoseki City, compare vaccination status between dentists and dental staff, identify factors associated with vaccination uptake, and describe self-reported reasons for non-vaccination.
2. Materials and Methods
2.1. Study Design
This cross-sectional observational study was conducted using a web-based questionnaire and is reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies. The target population consisted of members of the Shimonoseki Dental Association and their clinic staff. The Shimonoseki Dental Association determined that 470 DHWs were eligible based on the number of member dentists and staff working at their respective clinics. Accordingly, a total of 470 DHWs (dentists and dental staff) were invited to participate. Dental staff included dental hygienists, dental technicians, dental assistants, and reception/administrative staff; detailed occupational categories within the dental staff group were not collected in the questionnaire. Eligibility included employment in a dental clinic, age ≥18 years, and the ability to complete the online questionnaire.
In July 2025, the investigators provided the Shimonoseki Dental Association with 470 printed study booklets for individual distribution to the eligible DHWs. Each booklet contained the ethics-approved study information and instructions for accessing the online survey via a QR code. No individual identifiers were assigned, and the same QR code was used for all participants to preserve anonymity. Participants completed the survey between 1 August and 31 October 2025. Reminder e-mails were sent through the Dental Association in mid-August, late September, and mid-October to improve the response rate. Responses were collected anonymously through a secure web form.
2.2. Study Items
The questionnaire was newly developed for this study based on the study objectives. Before the survey, the questionnaire was reviewed by the investigators and pretested for clarity, comprehensibility, and functionality of the web-based survey system. The questionnaire included the following items (Table 1):
Table 1.
Survey items and response options used in the questionnaire.
- Demographic characteristics (age group, sex, occupation [dentist or dental staff], employment status);
- Awareness and perception of infection control (recognition of infection prevention, sources of information, institutional support);
- HBV/HCV infection-related variables (history of HBV and HCV testing, history of needlestick and sharps injuries);
- HB vaccination status (vaccination history, number of doses, timing, multiple reasons for non-vaccination, and primary reason for non-vaccination).
2.3. Statistical Analysis
Differences between groups were analyzed using Pearson’s Chi-square test or Fisher’s exact test, as appropriate. Fisher’s exact test was used when expected cell counts were small; otherwise, Pearson’s Chi-square test was used. For categorical variables with more than two categories, an overall contingency-table test was performed rather than separate tests for individual categories. For the exploratory analysis of factors associated with HB vaccination uptake, respondents who reported receiving at least one dose of HB vaccine were classified as vaccinated, whereas those who reported no previous HB vaccination were classified as unvaccinated. Respondents with unknown HB vaccination history were excluded from analyses comparing vaccinated and unvaccinated groups. Three-dose completion was evaluated separately as a descriptive outcome. All analyses were exploratory and unadjusted, and no adjustment for multiple comparisons was performed. A two-sided p-value < 0.05 was considered statistically significant. Statistical analyses were conducted using JMP version 19 (SAS Institute, Inc., Cary, NC, USA).
2.4. Ethical Statements
The study protocol was approved by the Ethics Committee of Juntendo University Faculty of Medicine (approval number: E25-0014-M01) and conducted in accordance with the Declaration of Helsinki. No personally identifiable information was collected. Returning the completed online questionnaire was regarded as informed consent for study participation.
3. Results
3.1. Comparison Between Dentists and Dental Staff
Of the 470 DHWs invited, 66 responded to the questionnaire, yielding an overall response rate of 14.0% (Table 2). The respondents comprised 34 (51.5%) dentists and 32 (48.5%) dental staff. Significant differences were found between the two occupational groups in sex (p < 0.001), age group (p = 0.0023), and employment status (p = 0.0019).
Table 2.
Summary of survey responses by occupation.
No significant difference was found between the two groups in recognizing the importance of HBV infection prevention; however, the sources of information on HB vaccination differed significantly. Educational institutions and workplace training were cited more frequently by dentists (p = 0.0036 and p = 0.0178, respectively). Additionally, awareness of workplace policies recommending HB vaccination differed between groups, with a higher proportion of dentists reporting that vaccination was recommended at their workplace (p = 0.0374).
Dentists were more likely to have undergone HBV and HCV testing (p = 0.0068 and p = 0.0141); however, no significant difference was found in needlestick/sharps injury experience. HB vaccination coverage was higher among dentists, whereas many dental staff remained unvaccinated (p = 0.0025). Of the 66 respondents, 33 (50.0%) had a history of HB vaccination, and only 15 (22.7%) had completed the full three-dose series. Completion rates were significantly (p = 0.0025) lower among dental staff (6.3%) than among dentists (38.2%). Unvaccinated individuals accounted for 40.9% overall, and were more common among dental staff (62.5%). The distribution of time since the last HB vaccination differed significantly between dentists and dental staff (p < 0.001), with dentists more likely to have been vaccinated over 10 years ago.
3.2. Reasons for Not Receiving the HB Vaccine
Among the 27 unvaccinated respondents who provided multiple responses (Table 3), the most frequent reason was “never personally recommended vaccination by a doctor or specialist” (48.1%), followed by “lack of knowledge about the vaccine” (14.8%). Dental staff more often selected “never recommended,” “lack of knowledge,” and “concerns about side effects,” whereas dentists more frequently selected “doubt about vaccine efficacy,” “previous infection,” and “lack of time.”
Table 3.
Reasons for not receiving hepatitis B vaccination (multiple responses).
Similarly, single-choice responses (Table 4) showed “never personally recommended vaccination by a doctor or specialist” as the most common primary reason (37.0%), followed by “lack of knowledge” (14.8%). Items such as “I don’t feel it is necessary” were selected only by dental staff, not by dentists.
Table 4.
Main reasons for not receiving hepatitis B vaccination (primary responses).
3.3. Comparison Between HB-Vaccinated and Unvaccinated Individuals
For the exploratory comparison of factors associated with HB vaccination uptake, respondents who reported receiving at least one dose of HB vaccine were classified as vaccinated. After excluding 6 respondents with unknown vaccination history, 60 were classified into vaccinated (n = 33) and unvaccinated (n = 27) groups (Table 5). Significant differences were observed between groups in occupation (p < 0.001) and sex (p = 0.0040); vaccinated individuals included more dentists and males while unvaccinated individuals included more dental staff and females. No significant differences in age or employment status were observed (Table 5).
Table 5.
Characteristics of dental healthcare workers vaccinated and unvaccinated against hepatitis B.
Vaccinated respondents were more likely to have obtained information about HB vaccination from educational institutions (universities or vocational schools) than unvaccinated respondents (72.7% vs. 18.5%, p < 0.001). Awareness of workplace policies regarding HB vaccination also differed significantly (p = 0.0363). Vaccinated respondents more frequently selected “actively recommended” or “recommended but left to individual judgment,” while unvaccinated respondents more frequently selected “not particularly recommended.”
Finally, vaccinated individuals were more likely to have undergone infection testing for HBV (p < 0.001) and HCV (p < 0.001). No significant difference in the experience of needlestick or sharps injuries was observed between the two groups (p = 0.1694).
4. Discussion
This study examined HB vaccination coverage and factors associated with vaccine uptake among DHWs in Shimonoseki City. The completion rate of the three-dose HB vaccine series was low at 22.7%, despite 50.0% of respondents reporting prior HB vaccination; this was particularly evident among dental staff, where the completion rate was only 6.3%, remaining below the level recommended by national guidelines [5]. This trend of low vaccination rates among dental staff aligns with findings from previous studies in Oita Prefecture, which reported “low vaccination rates” and “disparities in understanding hepatitis” [7,8]. These findings suggest that low HB vaccination coverage among dental staff may not be unique to Shimonoseki.
In contrast to dentists, dental hygienists, and dental technicians, who are governed by national licensure and standardized educational curricula, dental assistants in Japan are not subject to a national qualification system, and their training is not nationally standardized [13]. Such differences in professional training may be relevant to access to infection-control education and occupational vaccination programs. However, because detailed occupational categories within the dental staff group were not collected in this study, their contribution to the observed low vaccination completion rate could not be assessed.
Furthermore, we found associations between HB vaccination and “information obtained from educational institutions,” “history of HBV/HCV testing,” and “workplace vaccination promotion policies.” These findings indicate associations between HB vaccination status and educational exposure, HBV/HCV testing history, and reported workplace vaccination policies. These findings are also consistent with the WHO implementation framework for vaccination of health workers, which emphasizes the integration of health worker vaccination into occupational health and safety policies and programs and into health-facility management practices [14]. Notably, the higher vaccination rate among individuals who received information from educational institutions supports the potential role of pre-graduate education in shaping vaccination behavior. A similar association has been reported previously [7,15], suggesting that infection-control education may be relevant to vaccination uptake.
In addition, the observed association between reported workplace vaccination recommendations and vaccination status suggests a potential role of organizational support. In Japan, HB vaccination for adult DHWs is implemented primarily as an occupational infection-control measure rather than through the universal childhood immunization program [5]. Therefore, access to vaccination may depend partly on the policies and practices of individual dental institutions. Because dental clinics in Japan are generally small-scale workplaces, dentists who manage these clinics often have a direct role in determining and implementing workplace infection-control policies, including recommendations for HB vaccination. Thus, the awareness and attitudes of dentists responsible for clinic management may be relevant to vaccination uptake among dental staff.
The present finding that lack of personal recommendation was the most common reason for non-vaccination suggests that lack of systematic recommendation and support at the workplace level may be associated with lower vaccine uptake. Reports from other countries also indicate significant differences in HB vaccination rates among DHWs depending on the country and its healthcare system. More recent international evidence supports the persistence of this problem: a 2026 systematic review and meta-analysis across 30 countries found that complete HB vaccination among nurses remained suboptimal and highlighted structural barriers to vaccine uptake [12]. For example, the completion rate for three doses of the HB vaccine among dentists in Nigeria was low at 20% [16]. Similarly low rates below 30% have been reported among dentists and dental assistants in Laos [17]. Additionally, the serological immunity acquisition rate remained low at 13.6% in the Laos study (below 15%). Among dentists in Campo Grande, Brazil, 96.6% had vaccination history, with 73.1% having completed three doses [18], while in Saudi Arabia, 80.5% of dentists were reported to be vaccinated [19]. In Switzerland, HB vaccination coverage among DHWs has been reported to exceed 90% [20]. Many of these studies indicated that differences in institutional support—such as pre-graduate education, workplace vaccination mandates, cost coverage, and the presence of organized infection control programs—may contribute to disparities in vaccination rates [16,19]. The results of the current study align with these international findings that education and institutional support are important for promoting vaccination.
Older DHWs may include individuals with a higher likelihood of past HBV infection [8,11], for whom vaccination is not medically indicated; this possibility should be taken into account when interpreting vaccination rates.
Needlestick and cut injuries were not significantly associated with vaccination status in the present study. Although occupational exposure to blood and body fluids represents an important risk for HBV infection [21], the present survey assessed only whether respondents had ever experienced a needlestick or cut injury and did not collect information on the number, timing, or severity of such incidents. Therefore, the temporal relationship between occupational exposure and HB vaccination could not be evaluated. Previous studies have also reported substantial underreporting of needlestick injuries among healthcare workers [22,23]. Accordingly, the present finding should be interpreted cautiously and does not indicate that occupational exposure is unrelated to HB vaccination behavior.
A history of HBV/HCV testing was significantly associated with HB vaccination status in the present study. However, because the timing, type, and reasons for HBV/HCV testing were not collected, the temporal relationship between testing and vaccination could not be determined. Both testing and vaccination may reflect greater awareness of infection prevention or a stronger infection-control culture rather than a direct pathway from testing to vaccination. Our previous research showed higher HBV/HCV infection rates among DHWs than among general blood donors [11] and identified HBV infection among some unvaccinated DHWs [8]. These findings underscore the importance of both appropriate hepatitis virus testing and HB vaccination as components of occupational infection-control measures, while their causal relationship requires further investigation.
For healthcare personnel at risk of occupational exposure, post-vaccination serological testing for anti-HBs is recommended 1–2 months after completion of the HB vaccine series. Importantly, immunocompetent healthcare personnel with a documented anti-HBs level of ≥10 mIU/mL after completion of the primary series are considered to have long-term protection and do not require periodic anti-HBs testing; therefore, elapsed time since vaccination alone should not be interpreted as evidence of loss of protection or a need for booster vaccination [24].
Based on the above results, the following three points are considered particularly important to promote HB vaccination among DHWs: ensuring adequate infection control and vaccine education throughout all career stages, beyond pre-graduate training; clarifying vaccination promotion policies at the clinic level and providing institutional support; and promoting appropriate HBV/HCV testing and HB vaccination as complementary occupational infection-control measures. Concrete measures could include workplace-based HB vaccination programs, reminder systems, continuing education throughout all career stages, and financial support to reduce vaccination costs.
This study has several limitations. First, the response rate was low (14.0%), raising the possibility of selection bias and limiting the generalizability of the findings. Because information on nonrespondents was not available, the characteristics of respondents and nonrespondents could not be compared. In addition, individuals with greater awareness of hepatitis or infection control may have been more likely to participate. Therefore, the respondents may not be representative of all DHWs in Shimonoseki City. Second, HB vaccination history was self-reported and was not verified using vaccination records or serological markers such as anti-HBs. Accordingly, the reported vaccination coverage may be subject to recall or misclassification bias, and immunity against HBV could not be assessed. Therefore, the vaccination estimates in this study should be interpreted as self-reported vaccination history rather than objectively verified vaccination coverage. Future occupational health programs should incorporate appropriate post-vaccination anti-HBs testing to objectively assess seroprotection among DHWs. Third, because of the cross-sectional design, temporal or causal relationships between HB vaccination and the associated factors identified in this study cannot be established. The analyses were exploratory and unadjusted because of the limited sample size, and residual confounding cannot be excluded. In addition, because clinic identifiers were not collected, potential clustering of respondents within the same dental clinic could not be assessed or accounted for. Fourth, detailed occupational categories within the dental staff group were not collected, although this group included dental hygienists, dental technicians, dental assistants, and reception/administrative staff. Therefore, possible differences among these occupational subgroups could not be evaluated. Future studies should examine HB vaccination uptake separately across specific dental staff occupations. Fifth, the survey collected only the presence or absence of a history of needlestick or cut injuries and did not assess their number, timing, or severity. The lack of a significant association with needlestick or cut injury history may reflect limited statistical power or recall bias, or limitations in the exposure measure; therefore, this finding should be interpreted cautiously. Similarly, the timing, type, and reasons for HBV/HCV testing were not collected. In addition, the questionnaire was newly developed for this study and underwent pretesting for clarity and functionality, but formal psychometric validation, including test–retest reliability assessment, was not performed. Finally, the analysis of reasons for non-vaccination was based on only 27 unvaccinated respondents, resulting in small cell counts for several response categories. These findings should therefore be regarded as exploratory and hypothesis-generating and interpreted with caution. Nevertheless, this study provides an exploratory assessment of HB vaccination practices and factors associated with vaccine uptake among DHWs, including educational exposure, testing history, and reported workplace vaccination policies.
Future comparative studies across multiple regions, as well as intervention studies verifying the effects of educational programs, workplace policies, and testing opportunities on vaccination behavior, are desirable. The findings from this study can serve as foundational data to support HBV infection control measures and enhance patient safety in dental healthcare settings.
5. Conclusions
Among respondents, self-reported completion of the three-dose hepatitis B vaccination series was low, particularly among dental staff. HB vaccination status was associated with educational exposure, previous HBV/HCV testing, and reported workplace vaccination policies, whereas no association with self-reported needlestick or cut injury history was observed. These findings suggest that educational and organizational factors may be relevant to improving HB vaccination uptake among DHWs.
Author Contributions
Conceptualization, Y.N.; methodology, Y.N.; formal analysis, Y.N. and K.T.; investigation, Y.N.; data curation, Y.N. and K.T.; writing—original draft preparation, Y.N.; writing—review and editing, Y.N. and K.T. All authors have read and agreed to the published version of the manuscript.
Funding
This study was partly supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI Grant-in-Aid for Scientific Research (C). Grant number JP26K13005.
Institutional Review Board Statement
The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Juntendo University Faculty of Medicine (approval number: E25-0014-M01; approval date: 10 April 2025).
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
Data Availability Statement
The data supporting the findings of this study are available from the corresponding author upon reasonable request.
Acknowledgments
We would like to thank Shuei Yoshikawa for his support of our study. We also thank Takeshi Tanigawa for his coordination of the institutional ethics review procedures.
Conflicts of Interest
The authors declare no conflicts of interest. The funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.
Abbreviations
The following abbreviations are used in this manuscript:
| DHWs | Dental healthcare workers |
| HBsAg | Hepatitis B surface antigen |
| HBV | Hepatitis B virus |
| HCV | Hepatitis C virus |
References
- International Agency for Research on Cancer. Global Cancer Observatory: GLOBOCAN 2022. Japan Fact Sheet. Available online: https://gco.iarc.who.int/media/globocan/factsheets/populations/392-japan-fact-sheet.pdf (accessed on 27 November 2025).
- Nakano, M.; Kawaguchi, M.; Nakano, D.; Sano, T.; Amano, K.; Nakamura, T.; Takahashi, H.; Tarasawa, K.; Fujimori, K.; Kawaguchi, T. Regional Difference of Liver Cancer in Japan: A Real-world Evidence Using the National Database of Health Insurance Claims. Intern. Med. 2025, 64, 2263–2269. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Shiraki, K.; Eto, T. National project on the prevention of mother-to-infant infection by hepatitis B virus in Japan. Acta Paediatr. Jpn. 1988, 30, 194–196. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Tanaka, J.; Akita, T.; Ko, K.; Miura, Y.; Satake, M. Countermeasures against viral hepatitis B and C in Japan: An epidemiological point of view. Hepatol. Res. 2019, 49, 990–1002. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Japanese Society for Infection Prevention and Control. Guideline for Vaccination for Healthcare Professionals, 5th ed. Jpn. J. Environ. Infect. 2026, 41, S1–S54. (In Japanese) [Google Scholar]
- Nagao, Y.; Matsuoka, H.; Kawaguchi, T.; Ide, T.; Sata, M. HBV and HCV infection in Japanese dental care workers. Int. J. Mol. Med. 2008, 21, 791–799. [Google Scholar] [CrossRef] [Scilit]
- Nagao, Y.; Kimura, T.; Tomooka, K.; Wakita, H. Education and awareness activities regarding hepatitis B and C among Japanese dental health workers in the Oita prefecture. Cureus 2022, 14, e29670. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Nagao, Y.; Kimura, T.; Tomooka, K.; Wakita, H. Hepatitis B and C infections among Japanese dental health workers: Insights from vaccination rates and screening results in the Oita prefecture. Clin. Exp. Dent. Res. 2024, 10, e871. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Nagao, Y.; Sata, M. Hepatitis C virus and lichen planus. J. Gastroenterol. Hepatol. 2004, 19, 1101–1113. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Aliberti, A.; Gasparro, R.; Mignogna, M.; Canfora, F.; Spagnuolo, G.; Sammartino, G.; Coppola, N. Unveiling the oral lesions, dysgeusia and osteonecrosis related to COVID-19: A comprehensive systematic review. J. Clin. Med. 2025, 14, 1267. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Nagao, Y.; Kimura, T.; Nagao, H. Analysis of hepatitis B and C virus infections amongst members of the Dental National Health Insurance Society in the Oita prefecture. Biomed. Rep. 2021, 14, 23. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Cheng, D.; Duan, D. Global uptake of complete hepatitis B vaccination among nurses: A systematic review and meta-analysis. J. Hosp. Infect. 2026, 172, 250–260. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Zaitsu, T.; Saito, T.; Kawaguchi, Y. The Oral Healthcare System in Japan. Healthcare 2018, 6, 79. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- World Health Organization. Implementation Guide for Vaccination of Health Workers. Available online: https://www.who.int/publications/i/item/9789240052154 (accessed on 24 September 2026).
- Yared, G.; Sokhn, E.S.; Al-Khatib, A.; Kassis, C.; Younes, R. Knowledge, Attitude, and Practice of Hepatitis B Vaccination among Dentists in Lebanon. J. Contemp. Dent. Pract. 2024, 25, 134–140. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Azodo, C.; Ehizele, A.; Uche, I.; Erhabor, P. Hepatitis-B vaccination status among dental surgeons in benin city, Nigeria. Ann. Med. Health Sci. Res. 2012, 2, 24–28. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Mangkara, B.; Xaydalasouk, K.; Chanthavilay, P.; Kounnavong, S.; Sayasone, S.; Muller, C.P.; Paboriboune, P.; Black, A.P. Hepatitis B virus in Lao dentists: A cross-sectional serological study. Ann. Hepatol. 2021, 22, 100282. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Batista, S.M.; Andreasi, M.S.; Borges, A.M.; Lindenberg, A.S.; Silva, A.L.; Fernandes, T.D.; Pereira, E.F.; Basmage, E.A.; Cardoso, D.D. Seropositivity for hepatitis B virus, vaccination coverage, and vaccine response in dentists from Campo Grande, Mato Grosso do Sul, Brazil. Mem. Inst. Oswaldo Cruz 2006, 101, 263–267. [Google Scholar] [CrossRef] [Scilit] [PubMed][Green Version]
- Al-Dharrab, A.A.; Al-Samadani, K.H. Assessment of hepatitis B vaccination and compliance with infection control among dentists in Saudi Arabia. Saudi Med. J. 2012, 33, 1205–1210. [Google Scholar] [CrossRef] [Scilit]
- Zeller, B.; Kulik, E.M.; Zitzmann, N.U.; Waltimo, T. Awareness of vaccine-preventable diseases and self-reported immune status of Swiss dental healthcare workers. Swiss Med. Wkly. 2021, 151, w30036. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Beltrami, E.M.; Williams, I.T.; Shapiro, C.N.; Chamberland, M.E. Risk and management of blood-borne infections in health care workers. Clin. Microbiol. Rev. 2000, 13, 385–407. [Google Scholar] [CrossRef] [PubMed]
- Bahat, H.; Hasidov-Gafni, A.; Youngster, I.; Goldman, M.; Levtzion-Korach, O. The prevalence and underreporting of needlestick injuries among hospital workers: A cross-sectional study. Int. J. Qual. Health Care 2021, 33, mzab009. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Pervaiz, M.; Gilbert, R.; Ali, N. The prevalence and underreporting of needlestick injuries among dental healthcare workers in Pakistan: A systematic review. Int. J. Dent. 2018, 2018, 9609038. [Google Scholar] [CrossRef] [Scilit] [PubMed]
- Schillie, S.; Vellozzi, C.; Reingold, A.; Harris, A.; Haber, P.; Ward, J.W.; Nelson, N.P. Prevention of hepatitis B virus infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm. Rep. 2018, 67, 1–31. [Google Scholar] [CrossRef] [Scilit] [PubMed]
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.