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Am J Perinatol 2022; 39(09): 0980-0986
DOI: 10.1055/s-0040-1721372
Original Article

Hepatitis B Vaccination of Low Birth Weight Infants in Washington State

Katarina Ost 
1   Seattle Children's Research Institute, Seattle, Washington
,
Natalia V. Oster
2   Department of Biostatistics, University of Washington, Seattle, Washington
,
Elizabeth N. Jacobson
3   Department of Pediatrics, University of Washington, Seattle, Washington
,
M. Patricia deHart
4   Office of Immunization and Child Profile, Washington State Department of Health, Olympia, Washington
,
Janet A. Englund
1   Seattle Children's Research Institute, Seattle, Washington
3   Department of Pediatrics, University of Washington, Seattle, Washington
,
Annika M. Hofstetter 
1   Seattle Children's Research Institute, Seattle, Washington
3   Department of Pediatrics, University of Washington, Seattle, Washington
› Author Affiliations Funding A.M.H. is supported by a Mentored Clinical Scientist Research Career Development Award from the Agency for Healthcare Research and Quality (K08HS025470).
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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

  • Low birth weight infants are at increased risk for vaccine preventable diseases.

  • Many of these vulnerable infants failed to receive their first hepatitis B vaccine on time.

  • This study identified key factors associated with timely hepatitis B vaccination.

Keywords

hepatitis B - vaccination - low birth weight - infant - hospital

Supplementary Material



Publication History

Received: 16 July 2020

Accepted: 19 October 2020

Article published online:
30 November 2020

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