Hepatitis B Birth Dose: First Shot at Timely Early Childhood Vaccination

Area of Science:

• Pediatrics
• Immunology
• Public Health

Background:

• Current U.S. guidelines recommend a birth dose of the hepatitis B vaccine for newborns weighing ≥2,000 grams.
• However, approximately 25% of eligible newborns do not receive this initial dose as scheduled.
• The association between timely hepatitis B vaccination and the completion of other early childhood vaccines is not well understood.

Purpose of the Study:

• To investigate the relationship between receiving the hepatitis B vaccine during birth hospitalization and the timely completion of the recommended childhood vaccine series.
• To determine if early hepatitis B vaccination influences adherence to the full immunization schedule by 19 months of age.

Main Methods:

• A retrospective cohort study included 9,080 newborns (birth weight ≥2,000 grams) from an urban academic medical center in Washington State (2008-2013).
• Multivariable logistic regression analysis was employed to assess the association between birth dose hepatitis B vaccination and completing the seven-vaccine series by 19 months.
• Analyses adjusted for sociodemographic, clinical, and birth hospitalization factors. Data were analyzed in 2017-2018.

Main Results:

• 75.5% of infants received the hepatitis B vaccine during their birth hospitalization; 53.6% completed the seven-vaccine series by 19 months.
• Infants who received the hepatitis B vaccine at birth were significantly more likely to complete the seven-vaccine series by 19 months (60.0%) compared to those unvaccinated at discharge (33.8%; p<0.001).
• The adjusted odds of completing the seven-vaccine series were almost three times higher for infants who received the birth dose of hepatitis B vaccine (AOR=2.92, 95% CI=2.61-3.26).

Conclusions:

• Receipt of the hepatitis B vaccine during birth hospitalization is independently associated with a higher likelihood of completing all recommended childhood vaccines by 19 months.
• These findings underscore the critical role of the birth dose hepatitis B vaccine in establishing a pattern of timely vaccination.
• Further research is needed to explore factors influencing parental decisions regarding the birth dose and its impact on subsequent vaccination adherence.