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Hospital, Maternal and Birth Factors Associated With Hepatitis B Vaccination at Birth: West Virginia, 2015

Massey, Joel, MD*,†; Nair, Anil, PhD; Dietz, Stephanie, PhD§; Snaman, Deborah, BSN; Bixler, Danae, MD

The Pediatric Infectious Disease Journal: July 2018 - Volume 37 - Issue 7 - p 691–696
doi: 10.1097/INF.0000000000001953
Maternal-Neonatal Reports
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Background: Hepatitis B virus is a bloodborne pathogen typically transmitted through sexual contact, injection drug use or perinatally. A hepatitis B vaccine (HepB) is available; the first dose is recommended at birth. We sought to identify hospital policy, maternal characteristics and birth factors associated with HepB receipt at birth in West Virginia.

Methods: We conducted a retrospective cohort study of West Virginia live births in 2015 using vital records matched to immunization registry records to determine frequency of HepB birth dose receipt (<3 days postdelivery). We surveyed all West Virginia birthing facilities in 2015 (N = 26) about perinatal hepatitis B virus prevention policies. We examined associations of hospital policy, maternal characteristics and birth factors with HepB receipt at birth by using a mixed-effects regression model to calculate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs).

Results: Of 17,458 births, 14,006 (80.2%) infants received a HepB birth dose. Hospital use of preprinted newborn routine admission vaccination orders was associated with HepB birth dose receipt (aPR: 10.60; 95% CI: 2.12–52.72). Not using illicit drugs during pregnancy, maternal age <35 years and weekday births were associated with HepB birth dose receipt (aPR: 1.81; 95% CI: 1.54–2.13; aPR: 1.34, 95% CI: 1.17–1.54 and aPR: 1.15; 95% CI: 1.03–1.28, respectively).

Conclusions: Hospitals using preprinted admission orders had higher frequencies of HepB birth dose receipt. Additional study is needed to identify HepB birth dose receipt barriers among infants with maternal illicit drug use, maternal age ≥35 years or deliveries during a weekend.

From the *Epidemic Intelligence Service, Center for Surveillance Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia

Division of Infectious Disease Epidemiology

Division of Epidemiologic Informatics and Evaluation, West Virginia Bureau for Public Health, Charleston, West Virginia

§Epidemiology Workforce Branch, Center for Surveillance Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia

Division of Immunization Services, West Virginia Bureau for Public Health, Charleston, West Virginia.

Accepted for publication December 22, 2017.

The authors have no funding or conflicts of interest to disclose.

Address for correspondence: Joel Massey, MD, Office of Academic Affairs, Texas Department of State Health Services, Moreton Building 2-27, 1100 W 49th Street, Austin, TX 78756. E-mail: joel.massey@dshs.texas.gov.

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