Hepatitis B Vaccination of Low Birth Weight Infants in Washington State

Abstract

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

Persistence of antibodies 5 years after hepatitis B vaccination in preterm birth children: A retrospective cohort study using real‐world data

“…On the one hand, the birth dose of HepB among them showed considerable delay. [23][24][25] The present study also found that only 45.9% of preterm infants received their birth dose of HepB on time, compared to 93.5% in the full-term group. On the other hand, preterm infants may not be able to elicit a strong immune response after HepB vaccination due to their underdeveloped immune function, which is characterized by fewer absolute numbers of lymphocytes, T cells, B cells and T-helper cells.…”

“…Preterm infants are a unique population for whom HepB vaccination and the long‐term persistence of its immune response are also matters of great concern. On the one hand, the birth dose of HepB among them showed considerable delay 23–25 . The present study also found that only 45.9% of preterm infants received their birth dose of HepB on time, compared to 93.5% in the full‐term group.…”