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Hepatitis B Vaccination of Low Birth Weight Infants in Washington State
Katarina Ost1, Natalia V Oster2, Elizabeth N Jacobson3
1Seattle Children's Research Institute, Seattle, Washington.
Insights
Many low birth weight infants miss their hepatitis B (HepB) vaccine birth dose on time. This study identified factors like race and gestational age affecting timely HepB vaccination for vulnerable infants.
Area of Science:
- Pediatrics
- Immunology
- Public Health
Background:
- Low birth weight infants (<2,000g) are at higher risk for vaccine-preventable diseases.
- The U.S. Advisory Committee on Immunization Practices (ACIP) recommends timely hepatitis B (HepB) vaccination for these infants.
Purpose of the Study:
- To assess the rate of timely HepB birth dose vaccination among infants weighing less than 2,000g.
- To identify factors associated with delayed HepB vaccination in this high-risk population.
Main Methods:
- Retrospective cohort study of infants born weighing <2,000g between 2008-2013.
- Data linkage between electronic health records and the Washington State Immunization Information System.
- Multivariable logistic regression analysis to determine associations with timely HepB vaccination.
Main Results:
- Only 58.4% of 976 low birth weight infants received the HepB vaccine by hospital discharge or 30 days of age.
- Hispanic and non-Hispanic Black infants had higher odds of timely vaccination compared to non-Hispanic White infants.
- Factors associated with lower odds of timely vaccination included prematurity (<34 weeks gestation) and lower household income (<$50,845).
Conclusions:
- A significant proportion of low birth weight infants do not receive the HepB birth dose on time.
- Targeted strategies are necessary to improve timely HepB vaccination rates in this vulnerable population.
- Understanding sociodemographic and clinical factors is crucial for improving vaccine uptake.
Objective:
The U.S. Advisory Committee on Immunization Practices (ACIP) recommends that infants born weighing less than 2,000 g receive the hepatitis B (HepB) vaccine at hospital discharge or 30 days of age. This study aimed to assess timely HepB vaccination among low birth weight infants. We hypothesized that many of these vulnerable infants would fail to receive their HepB birth dose on time.
Study Design:
This retrospective cohort study included Washington State infants born weighing less than 2,000 g at an academic medical center between 2008 and 2013. Data were abstracted from electronic health records and linked to vaccine data from the Washington State Immunization Information System. Multivariable logistic regression was used to examine the associations between sociodemographic, clinical, and visit characteristics and HepB vaccination by birth hospitalization discharge or 30 days of age.
Results:
Among 976 study infants, 58.4% received their HepB vaccine by birth hospitalization discharge or 30 days of age. Infants had higher odds of timely HepB vaccination if they were Hispanic (adjusted odds ratio [AOR] = 1.80, 95% confidence interval [CI]: 1.10-2.95) or non-Hispanic black (AOR = 2.28, 95% CI: 1.36-3.80) versus non-Hispanic white or if they were hospitalized 14 days or longer versus less than 14 days (AOR = 2.43, 95% CI: 1.66-3.54). Infants had lower odds of timely HepB vaccination if they were born before 34 weeks versus on or after 34 weeks of gestational age (AOR = 0.41, 95% CI: 0.27-0.63) or if they had an estimated household income less than $50,845 versus 50,845 or greater (AOR = 0.64, 95% CI: 0.48-0.86).
Conclusion:
Many infants born weighing less than 2,000 g did not receive their first HepB birth dose according to ACIP recommendations. Strategies are needed to improve timely HepB vaccination in this high-risk population.
Key Points:
· Low birth weight infants are at increased risk for vaccine preventable diseases.. · Many of these vulnerable infants failed to receive their first hepatitis B vaccine on time.. · This study identified key factors associated with timely hepatitis B vaccination..
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