Impact on health departments after a seventh grade hepatitis B immunization requirement

This research was designed to evaluate the impact on health departments of the implementation of a 1999 policy requiring hepatitis B (HBV) vaccination for seventh grade school entry in the state of Missouri.

The authors employed a retrospective descriptive design using data from the Missouri Health Strategic Architectures and Information Cooperative (MOHSAIC) system. They based their assessment of the impact of the new policy on six outcome variables: total immunizations administered, HBV immunizations administered, HBV immunizations given to children ages 10 to 14, percentage of total immunizations that were HBV, percentage of total HBV immunizations that were given to children ages 10 to 14, and percentage of total immunizations that were HBV given to children ages 10 to 14. Outcome variables from the months of July through September 1998 were compared to similar data from the same period in 1999.

Statewide, there was a significant increase in all outcome variables. Health departments in non-rural settings, however, did not have a significant increase in total immunizations (t = -1.49, p = 0.158). The number of HBV immunizations did increase at health departments where alternative strategies (e.g., school-based programs) were used, but the increase was not as dramatic as for sites where no such strategies were employed.

Implementation of a state policy requiring additional immunizations can be expected to have a significant impact on the resources of health departments statewide. The use of alternative strategies for managing immunizations outside the traditional health department setting can limit that impact.