Decreasing Vaccination Coverage Against Hepatitis B and Tuberculosis in Newborns

The number of parents who refuse to vaccinate their children or present the so-called hesitant behavior, i.e., delay the moment of vaccination beyond the mandatory time, has increased in many developed countries. The purpose of this retrospective study was to evaluate the completeness and timeliness of vaccinations against hepatitis B (HBV) and tuberculosis (TB) in neonates in a single maternity hospital in Warsaw, Poland. We reviewed medical files of 14,785 children born in the hospital in 2015-2017 and calculated the proportion of newborns not vaccinated on time according to the Polish Immunization schedule that includes vaccination against HBV and TB in the first day of life. Newborns remained unvaccinated because of parental refusal (refusers) or decision for a delay (hesitants), or medical contraindications. The percentage of unvaccinated newborns in the 3 years was as follows: 7.3% in 2015, 6.7% in 2016, and 10.1% in 2017. Parental decisions rather than medical contraindications caused nonvaccination (4.4% vs. 2.9% in 2015, 4.7% vs. 2.0% in 2016, and 7.5% vs. 2.6% in 2017). The majority of refusals concerned both vaccinations (67.3% in 2015, 74.8% in 2016, and 68% in 2017). Among parents who refused only one vaccination, TB vaccination was refused more often than HBV (9.2% vs. 7.1% in 2015, 8.3% vs. 5.7% in 2016, and 5.9% vs. 2.7% in 2017). Similar trends were observed among the hesitants. In conclusion, it seems essential to implement effective educational and informative activities targeted to parents to reinforce positive attitudes toward vaccinations.