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Measuring hepatitis B uptake in a new universal infant program
Meenakshi Dawar1, Simon Dobson, Arlene Kallos
1Department of Health Care & Epidemiology, University of British Columbia, Vancouver, BC.
Insights
Universal infant hepatitis B immunization in Vancouver-Richmond achieved high coverage. Physician awareness is key to improving hepatitis B vaccine uptake in children.
Area of Science:
- Public Health
- Immunology
- Pediatrics
Background:
- Vancouver-Richmond Health Board faces high rates of hepatitis B, with 25 annual childhood cases (1994-1997).
- Existing adolescent immunization programs do not prevent childhood hepatitis B infections.
- Universal infant hepatitis B immunization was implemented in September 1998.
Purpose of the Study:
- To evaluate the initial year's success of the universal infant hepatitis B immunization program.
- To assess hepatitis B vaccine coverage rates in infants.
Main Methods:
- A random sample of 191 infants born in March 1999 was surveyed.
- Immunization coverage data were collected one year post-program initiation.
Main Results:
- 97.9% of infants received some vaccinations by eight months.
- 73.8% received three doses of hepatitis B vaccine; 12.6% received two doses.
- Physician awareness/acceptance (67%) was the primary barrier to hepatitis B vaccine uptake; only one parent cited adverse publicity.
Conclusions:
- The first year of the infant hepatitis B immunization program was successful and did not disrupt other childhood vaccination schedules.
- Enhancing physician and parent awareness can further improve hepatitis B vaccine uptake.
Background:
Vancouver-Richmond Health Board has the highest reported rate of hepatitis B in Canada, including an annual average of 25 cases in children under 12 years of age, based on reports from 1994-1997 inclusive. The current provincial adolescent grade-six hepatitis B immunization program does not protect against childhood infection. The regional health board implemented universal infant hepatitis B immunization in September 1998.
Method:
Immunization coverage data were obtained on a random sample of 191 infants born in March 1999 one year after initiation of the program.
Results:
By eight months of age, 97.9% of children had received some vaccinations. 73.8% of infants had received three doses of hepatitis B vaccine and 12.6% had received two doses. In comparison, 89% had received three doses and 7.9% two doses of DPTP-Hib vaccine. 13.1% of infants had not received any hepatitis B vaccine. For a majority (67%) of these children, their physician's lack of awareness or lack of acceptance of the program constituted the reason for no hepatitis B vaccine uptake. Only one parent cited adverse publicity as the reason for refusing vaccination.
Interpretation:
This survey reveals a successful first year of the program without harm to the pre-existing childhood vaccination programs. Hepatitis B vaccine uptake can be improved by increased awareness among physicians and parents.