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Newborn hepatitis B immunization rates in primary care practices
1Family Practice Residency Program, Latrobe Area Hospital, Pa, USA.
Insights
This study found a 77% hepatitis B immunization rate in infants by 18 months in primary care. Key barriers to complete hepatitis B vaccination included patient transfer and missed appointments.
Area of Science:
- Pediatrics
- Immunology
- Public Health
Background:
- Hepatitis B vaccination is crucial for preventing chronic infection.
- Primary care settings play a vital role in childhood immunization programs.
Purpose of the Study:
- To determine the hepatitis B immunization rate among newborns and infants.
- To identify factors contributing to incomplete hepatitis B immunization series.
Main Methods:
- An inception cohort study tracked newborns and infants in six primary care practices.
- Immunization status was assessed at 9 and 18 months of age.
- Reasons for incomplete immunization were recorded.
Main Results:
- Hepatitis B immunization rates reached 60% at 9 months and 77% by 18 months.
- Common reasons for incomplete immunization included patient transfer (7%), missed appointments (4%), and parental refusal (4%).
- By 18 months, 95% of infants received at least two doses of the hepatitis B vaccine.
Conclusions:
- A 77% hepatitis B immunization rate was achieved by 18 months in primary care.
- Barriers to complete hepatitis B vaccination include patient transfer, missed appointments, and parental refusal.
Objectives:
To assess the hepatitis B immunization rate and to identify the reasons for an incomplete immunization series in newborns and infants seen in primary care practices.
Design:
An inception cohort study enrolling newborns and infants and assessing their hepatitis B immunization status at 9 and 18 months of age.
Setting:
Six primary care offices, most in rural environments.
Patients:
All newborns and infants seen at 1 of 6 offices.
Intervention:
Infants born between January 1, 1993, and September 30, 1994, were followed up through June 30, 1995. Hepatitis B immunization status and the reasons for an incomplete status were recorded at each visit.
Main Outcome Measures:
Hepatitis B immunization rates at 9 and 18 months of age, and the reasons for immunization failure.
Results:
The immunization rates of infants aged 9 and 18 months were 60% and 77%, respectively. The most common reasons for inadequate immunization of the 247 infants followed up through age 18 months were patient transfer (7%), failing to return for a scheduled visit (4%), and guardians refusing the immunization (4%). Failure to return for a scheduled visit was the reason for the incomplete immunization in 13% of the 9-month-old infants. Immunization of these patients was the most important factor in the higher immunization rate at 18 months of age. By the age of 18 months, 95% of all infants had received at least 2 doses of the hepatitis B immunization.
Conclusions:
A hepatitis B newborn immunization rate of 77% by age 18 months was achieved in a primary care office setting. Barriers to complete immunization by the age of 18 months include patient transfer, patient failure to return, and parental refusal of immunization.