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ADHERENCE TO BIRTH DOSE OF HEPATITIS B VACCINATION IN THE HOUSTON METROPOLITAN AREA
Gastroenterology ; 162(7):S-1169, 2022.
Article in English | EMBASE | ID: covidwho-1967421
ABSTRACT

Introduction:

Perinatal infection with Hepatitis B virus (HBV) becomes chronic in 90% of cases with subsequent risk of developing serious liver disease. To prevent this, American Academy of Pediatrics has set recommendations for 3 groups of newborns weighing $ 2,000 grams (1) maternal Hepatitis B surface antigen (HbSAg) negative administration of HBV vaccine by 24 hours of life (HoL);(2) maternal HbSAg unknown administration of HBV vaccine by 12 HoL (and HBV immune globulin by hospital discharge if status remains unknown);and (3) maternal HbSAg positive administration of HBV vaccine and immune by 12 HoL. These timings maximize effectiveness of the HBV vaccine in preventing vertical transmission. Given poor compliance with current HBV vaccination demonstrated by the National Immunization Survey, this study aims to better understand factors associated with vaccine implementation at a large women's and children's center during the SARS-CoV-2 pandemic.

Methods:

This study was a retrospective chart review of newborns born from January 2019-September 2021 at Texas Children's Hospital in Houston, Texas (n=17,294). All newborns$2,000 grams were included and stratified by maternal HbSAg result (negative, unknown, or positive by 12 HoL) (see Figure). Univariate analysis was used to identify factors associated with timely receipt of the HBV vaccine and/or HBV immune globulin.

Results:

In the group with negative maternal HbsAg (n=17,185), 70.3% (n=12,077) received the HBV vaccine by 24 HoL. Those not receiving the vaccine prior to discharge (6.9%, n= 1,180) were more likely to be Caucasian, have commercial insurance, and not receive vitamin K or erythromycin. In the group with unknown maternal HbSAg (n=74), 17.6% (n=13) received the HBV vaccine by 12 HoL while 75.7% (n=56) received it between 12 HoL and discharge. In the group with positive maternal HbSAg (n=35), 91.4% (n=31) received the HBV vaccine and immune globulin by 12 HoL. Overall deviation from vaccination guidelines was highest in newborns admitted to intensive care units, and similar vaccination rates occurred in the period before and during the SARS-CoV-2 pandemic.

Conclusions:

Newborn HBV vaccination practices are not meeting American Academy of Pediatrics recommendations, which suggests a need to reevaluate current hospital protocol. Given that newborns with maternal HBV positive or unknown status are at highest risk of vertical transmission, initial interventions to improve timely vaccination should target these groups first, especially in intensive care settings. While 30% of newborns born to HbSAg negative mothers were not vaccinated by the recommended 24 HoL, only 7% had not received HBV vaccination prior to discharge. Dialog to increase HBV vaccine acceptance with individual families will likely be required to improve these rates. (Figure Presented)
Keywords

Full text: Available Collection: Databases of international organizations Database: EMBASE Topics: Vaccines Language: English Journal: Gastroenterology Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Topics: Vaccines Language: English Journal: Gastroenterology Year: 2022 Document Type: Article