Impact of Recommendations to Suspend the Birth Dose of Hepatitis B Virus Vaccine

Oram, Ronda J.; Daum, Robert S.; Seal, John; Lauderdale, Diane S.

doi:10.1001/jama.285.14.1874

Cited by 29 publications

(19 citation statements)

References 12 publications

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“…15,16 Although the suspension was lifted at the end of 1999, when manufacturers had removed thimerosal from most vaccines, including hepatitis B vaccine, the changes in policy statements have been shown to have an impact on newborn hepatitis B vaccine coverage levels. [17][18][19] These policy changes likely contributed to the delay in the resumption of the birth dose in early 2000 found in this study, with the lowest hepatitis B vaccination rates in January (48.5%) and February (67.5%). This is demonstrated by findings in records of infants who were born in January and February in a single hospital (n ϭ 5) of a medical exemption form signed by the parent agreeing to delay HBV vaccination until the infant was 6 months of age because of concerns regarding thimerosal.…”

Section: Discussionmentioning

confidence: 80%

Assessment of Perinatal Hepatitis B and Rubella Prevention in New Hampshire Delivery Hospitals

Bascom

Miller²,

Greenblatt³

2005

Pediatrics

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ABSTRACT.Objective. To evaluate current performance on recommended perinatal hepatitis B and rubella prevention practices in New Hampshire.Methods. Data were extracted from 2021 paired mother-infant records for the year 2000 birth cohort in New Hampshire's 25 delivery hospitals. Assessment was done on the following: prenatal screening for hepatitis B and rubella, administration of the hepatitis B vaccine birth dose to all infants, administration of hepatitis B immune globulin to infants who were born to hepatitis B surface antigen-positive mothers, rubella immunity, and administration of in-hospital postpartum rubella vaccine to rubella nonimmune women.Results. Prenatal screening rates for hepatitis B (98.8%) and rubella (99.4%) were high. Hepatitis B vaccine birth dose was administered to 76.2% of all infants. All infants who were born to hepatitis B surface antigenpositive mothers also received hepatitis B immune globulin. Multivariate logistic regression showed that the month of delivery and infant birth weight were independent predictors of hepatitis B vaccination. The proportion of infants who were vaccinated in January and February 2000 (48.5% and 67.5%, respectively) was less than any other months, whereas the proportion who were vaccinated in December 2000 (88.2%) was the highest. Women who were born between 1971 and 1975 had the highest rate of rubella nonimmunity (9.5%). In-hospital postpartum rubella vaccine administration was documented for 75.6% of nonimmune women.Conclusion. This study documents good compliance in New Hampshire's birthing hospitals with national guidelines for perinatal hepatitis B and rubella prevention and highlights potential areas for improvement. Pediatrics 2005;115:e594-e599. URL: www.pediatrics.org/ cgi

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Section: Discussionmentioning

confidence: 80%

Assessment of Perinatal Hepatitis B and Rubella Prevention in New Hampshire Delivery Hospitals

Bascom

Miller²,

Greenblatt³

2005

Pediatrics

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“…Our findings are consistent with previous reports indicating that 55% of infants received the birth dose before thimerosalrelated changes in birth dose practices and since the availability of thimerosal-free vaccine, rates have increased but not fully rebounded to their previous levels of immunization. [13][14][15] This study shows that most pediatricians are practicing within current recommendations regarding hepatitis B immunization of infants. In the awareness-to-adherence model, Pathman et al 17 showed that in regards to hepatitis B immunization, physicians generally must agree with a recommendation before they adopt it into their practice.…”

Section: Discussionmentioning

confidence: 93%

“…[12][13][14][15][16] Furthermore, the policy change was misinterpreted by some hospitals that even stopped immunizing infants of mothers who were not screened for HBsAg. 13 Our study blends into the literature by identifying factors associated with use of the birth dose and the desired role of pediatricians in establishing hospital policy for perinatal hepatitis B prevention.…”

Section: Discussionmentioning

confidence: 99%

“…10 This policy change caused a marked decrease in the use of the birth dose of hepatitis B vaccine, and after thimerosal preservative-free hepatitis B vaccines became available in October 1999, the rate of birth dose adminis-tration did not rebound to the levels seen before the temporary changes in the policy. [11][12][13][14][15] The addition of more vaccines and introduction of combination vaccines add to the increasingly complex infant immunization schedule. Combination vaccines will help to decrease the number of injections an infant receives at 1 visit, but they are not approved for administration at birth.…”

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confidence: 99%

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Attitudes, Practices, and Preferences of Pediatricians Regarding Initiation of Hepatitis B Immunization at Birth

et al. 2001

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ABSTRACT. Objectives. To explore practices and attitudes of pediatricians toward administration of the first dose of hepatitis B vaccine to infants, and to identify factors influencing the decision of pediatricians to initiate immunization at birth versus at 1 to 2 months of age.Methods. A random sample of 600 pediatricians obtained from the American Academy of Pediatrics membership database was surveyed by mail.Results. Three hundred eighty (68%) of the 563 pediatricians who were located responded to the survey. Of these 380 pediatricians, 279 provided routine immunizations to children. Of the 270 pediatricians who vaccinated children with hepatitis B vaccine and indicated their practice regarding the birth dose, 50% offered the first dose of hepatitis B vaccine at birth to all infants; the rest either offered the vaccine at birth only to infants of hepatitis B surface antigen-positive mothers and mothers whose serostatus is unknown, or did not offer the birth dose to any infants at all. Practicing in the inner city, working for a medical school or government hospital, and living in a state with universal immunization supply policies were associated with the respondent giving the birth dose. The strongest perceived barriers to giving the birth dose in the hospital were the difficulty tracking these vaccines (39%), the increased cost (27%), and the lack of reimbursement from insurance companies (26%). If a combination vaccine that includes hepatitis B; diphtheria, tetanus, pertussis (diphtheria and tetanus toxoids and acellular pertussis vaccine); and polio (inactivated poliovirus vaccine) antigens become available in the near future, then 38% of physicians who currently give the birth dose to all infants would prefer to wait until 2 months of age to initiate hepatitis B immunization.Conclusions. Efforts to achieve high implementation of hepatitis B birth dose administration may falter once a hepatitis B-containing pentavalent combination vaccine becomes available. Programmatic efforts should ensure prevention of perinatal hepatitis B virus transmission through universal prenatal hepatitis B surface antigen screening and immunoprophylaxis of high-risk newborn infants. Pediatrics 2001;108(6). URL: http://www. pediatrics.org/cgi/content/full/108/6/e98; policy, hepatitis B, immunization, infant, pediatrician, practice, provider, vaccination.

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“…For example, after the suspension of the birth dose of hepatitis B vaccine was lifted because a thimerosal-free formulation became available, Orum and colleagues documented a 35% decrease in hospital nurseries that routinely offered hepatitis B immunization 1 year after the recommendations were made. 21 Similarly discouraged physicians could create a hole in the public health infrastructure, reducing availability and potentially re-ducing vaccine coverage for years to come.…”

Section: Flu Vaccine Shor Tag E a Nd R Epe At Im Muniz At Ion R At Esmentioning

confidence: 99%

Impact of the 2004 Influenza Vaccine Shortage on Repeat Immunization Rates

Schade¹,

Hannah²

2006

The Annals of Family Medicine

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PURPOSEWe assessed the impact of the severe infl uenza vaccine shortage of 2004 on individual physicians' immunization performance. Using 1998Using -2004 Medicare claims data, we monitored the physician continuity rate (proportion of patients receiving infl uenza immunization from a physician in 1 year who received a subsequent immunization from the same physician the subsequent year) and other clinician rate (proportion of patients with claims from 1 physician in 1 year with a claim from another clinician the subsequent year) in West Virginia Medicare benefi ciaries from 2000-2004. We examined vaccine claim trends by clinician and surveys of self-reported immunization to determine whether patients received vaccine from nonphysician clinicians or went without immunization each year. METHODS RESULTS

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Impact of Recommendations to Suspend the Birth Dose of Hepatitis B Virus Vaccine

Abstract: We documented a 35% decrease in hospital nurseries that routinely offered HBV immunization 1 year after the AAP and PHS recommendations were made. Special efforts may be required to make at-birth administration of HBV vaccination universal.

Cited by 29 publications

References 12 publications

Assessment of Perinatal Hepatitis B and Rubella Prevention in New Hampshire Delivery Hospitals

Assessment of Perinatal Hepatitis B and Rubella Prevention in New Hampshire Delivery Hospitals

Attitudes, Practices, and Preferences of Pediatricians Regarding Initiation of Hepatitis B Immunization at Birth

Impact of the 2004 Influenza Vaccine Shortage on Repeat Immunization Rates

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