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Hepatitis B birth dose vaccination patterns in the military health System, 2014-2018

Jessica Fung Deerin1, Rebecca Clifton1, Angelo Elmi2

  • 1The George Washington University, Milken Institute School of Public Health, Department of Epidemiology, United States.

Vaccine
|March 20, 2021
PubMed

Insights

Hepatitis B (HepB) birth dose vaccination coverage increased from 2014 to 2018 in the Military Health System. However, parental refusal rates for the HepB vaccine also rose during this period.

Area of Science:

  • Public Health
  • Immunization
  • Pediatrics

Background:

  • The universal hepatitis B (HepB) birth dose vaccine is recommended for infants weighing ≥2,000g.
  • Timely HepB vaccination is crucial for preventing perinatal transmission from HBsAg-positive mothers.
  • Parental refusal is a growing concern impacting infant vaccination schedules.

Purpose of the Study:

  • To analyze trends in HepB birth dose vaccination coverage within the Military Health System (MHS).
  • To identify sociodemographic factors associated with delayed or missed HepB birth doses.
  • To assess the impact of parental refusal codes on vaccination patterns.

Main Methods:

  • Retrospective cohort analysis of MHS live births (2014-2018).
  • Utilized administrative claims data, including diagnosis and CPT codes for vaccination and refusal.
  • Employed generalized linear mixed effects models to identify factors associated with vaccination patterns.

Main Results:

  • HepB birth dose coverage increased from 79.6% (2014) to 88.1% (2018).
  • Parental refusal rates for the HepB vaccine increased from 3.7% (2014) to 4.5% (2018).
  • Factors linked to non-receipt included earlier birth year, white maternal race, higher maternal age, birth order, and longer hospital stay.

Conclusions:

  • HepB birth dose vaccination coverage is high and increasing in the MHS.
  • Concurrently, parental refusal of the HepB vaccine has also risen.
  • Administrative claims data effectively differentiate reasons for vaccine non-receipt.
Abstract

Keywords:
Hepatitis BHepatitis B birth dose vaccineParental refusalVaccine hesitancy

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