Improving Compliance With Revised Newborn Hepatitis B Vaccination Policy

Area of Science:

• Pediatrics
• Public Health
• Vaccinology

Background:

• Guidance issued in September 2017 recommended hepatitis B vaccine for newborns ≥2000g within 24 hours.
• Prior to interventions, only 35% of eligible newborns received the vaccine within 24 hours, despite 85% receiving it before discharge.

Purpose of the Study:

• To increase the rate of hepatitis B vaccination within 24 hours for eligible newborns to 70% by June 2018.
• To maintain the overall vaccination rate before discharge.

Main Methods:

• A multidisciplinary team analyzed and modified vaccine administration processes.
• Changes included streamlining order activation, consent procedures, and bundling vaccination with routine care.
• Parent communication shifted from offering the vaccine to recommending it.

Main Results:

• The proportion of infants vaccinated within 24 hours increased from 35.5% to 78.8%.
• This improvement demonstrated special-cause variation on statistical process control charts.
• The overall vaccination rate before discharge also rose from 86.5% to 92.3%.

Conclusions:

• Specific process improvements enabled the birth center to meet the recommended 24-hour timing for hepatitis B vaccination.
• The interventions successfully enhanced timely vaccination compliance for eligible newborns.