666 – Recent Advances of Statistical Application to the Health Policy Studies

Which Newborns Missed the First Dose of Hepatitis B Vaccination?

at National Center for Immunization and Respiratory Diseases

Background: In the 2002, the Advisory Committee on Immunization Practices (ACIP) indicated a preference for administering the first dose of hepatitis B vaccine for all infants soon after birth and before hospital discharge (birth dose). In 2005, the ACIP recommended the first dose of hepatitis B vaccine at birth routinely for all infants, to improve prevention of perinatal and early childhood hepatitis B virus (HBV) transmission.
Objective: Assess the prevalence of infants who missed the hepatitis B birth dose vaccination. Identify socio-demographic factors associated with non-receipt of the birth dose among infants in the United States. Methods: A cross-sectional prevalence study was conducted for non-receipt of the hepatitis B birth dose vaccination among 17,053 infants in the 2009 National Immunization Survey (NIS). Multivariable logistic regression analysis was applied to determine factors independently associated with not receiving the birth dose of hepatitis B vaccine. Results: Infants whose parents refused or delayed at least one vaccination were significantly less likely to receive the birth dose of hepatitis B vaccine compared to infants whose parents did not (adjusted Risk Ratio (RR) with 95% Confidence Interval 1.11(1.04, 1.19)). Lack of health insurance for infants was also significantly associated with non-receipt of the birth dose hepatitis B vaccine (adjusted RR 1.18 (1.08,1.28)). Infants residing in state without a universal supply policy for hepatitis B were significantly more likely to not receive the hepatitis B birth dose (adjusted RR 1.19 (1.11, 1.29)). Conclusions: Infants without health insurance, residing in states having not universal hepatitis B vaccine supply policy, and whose parent refused or delayed at least one vaccination were modifiable factors significantly associated with not receiving the birth dose of hepatitis B vaccination. Educating infants’parents and their providers on best vaccine practices will warrant increasing the hepatitis B birth dose vaccination rate in the US.