Racial Disparities in Hepatitis B Birth Dose in the Washington Metropolitan Region, 2018-2020
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Updated: Sep 3, 2025
Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
Published on: December 15, 2023
Hee-Soon Juon1, Donna T Sheler2, Jane Pan3
1Department of Medical Oncology, Thomas Jefferson University, 834 Chestnut Street Suite 314, Philadelphia, PA 19107, USA.
Insights
Hepatitis B birth dose vaccination increased from 2018-2020. However, African American infants received the Hepatitis B (HepB) vaccine less often than non-Hispanic Whites, indicating a need for further research.
Area of Science:
- Public Health
- Immunization
- Epidemiology
Background:
- Hepatitis B vaccination is crucial for preventing chronic infection, liver failure, and death in newborns.
- Understanding trends and racial disparities in Hepatitis B (HepB) birth dose administration is vital for public health initiatives.
Purpose of the Study:
- To examine trends and racial differences in Hepatitis B (HepB) birth dose vaccination rates among newborns in 2018–2020.
- To identify potential disparities in HepB birth dose administration based on race/ethnicity and health insurance.
Main Methods:
- Retrospective analysis of electronic birth dose vaccination data for 40,269 newborns from 2018–2020.
- Inclusion of maternal race/ethnicity, health insurance, and birthing facility data.
- Descriptive and multivariable logistic regression analyses, including subgroup analysis by insurance type.
Main Results:
- Overall HepB birth dose vaccination rates increased from 83.7% in 2018 to 87.7% in 2020.
- Asian American infants had the highest vaccination rates, while African American infants were less likely to receive the HepB birth dose compared to non-Hispanic Whites (aOR = 0.77).
- Significant interaction between race/ethnicity and health insurance type was observed.
Conclusions:
- While HepB birth dose vaccination rates are increasing, racial disparities persist.
- African American infants face lower rates of HepB birth dose vaccination, necessitating further investigation into hesitancy factors.
- Targeted interventions may be required to address disparities and improve HepB birth dose coverage in vulnerable populations.
Abstract:
Hepatitis B vaccination protects newborns from contracting the hepatitis B virus that may lead to chronic infection, liver failure, or death. Trends and racial differences in the administration of the hepatitis B (HepB) birth dose in 2018−2020 were examined in the targeted region. A retrospective analysis of electronic birth dose vaccination data of newborns in 2018−2020 was performed. Birth data from six birthing facilities and home delivery records were obtained from the DC Health Department Vital Statistics Division. This data represented 40,269 newborns and included the mother’s race and ethnicity, health insurance type, birthing facility, and administration of the HepB birth dose. Descriptive analysis and multivariable logistic regression analysis were conducted. In addition, subgroup analysis by health insurance type was also conducted with a significant interaction of race/ethnicity and health insurance type. A total of 34,509 (85.7%) received the HepB birth dose within 12 h or before discharge from the facility. The rates of birth dose vaccination have seen an increase over the 3-year period (83.7% in 2018, 85.8% in 2018, 87.7% in 2020, p < 0.01). Multivariable logistic regression analysis revealed racial differences in HepB birth dose vaccination rates. Asian Americans had the highest rate of newborn vaccination consistently over the 3-year period. Conversely, African American infants were less likely to have the birth dose than non-Hispanic Whites (aOR = 0.77, 95% CI: 0.71−0.83). Our research indicates that further studies are needed to explore HepB birth dose hesitancy among African Americans.
