Low hep B vaccination rates seen in newborns

NEW YORK (Reuters Health) - The results of a survey conducted by the US Centers for Disease Control and Prevention indicate that only about 50 percent of newborns receive a dose of hepatitis B vaccine before hospital discharge.

In 1991, the Advisory Committee on Immunization Practices recommended that all newborns receive the first dose of the vaccine before leaving the hospital or at age 1 to 2 months. In 2002, however, this recommendation was changed to indicate a preference for vaccination prior to hospital discharge. Finally, in 2005, the guidelines were again revised to recommend pre-hospital discharge hepatitis B vaccination for all medically stable infants weighing at least 2000 grams (4 pounds 6.5 ounces).

The present findings are based on an analysis of survey data obtained after the 2002 guidelines were implemented but before the 2005 ones were in place.

Overall, 43 percent of newborns received the first dose of the hepatitis B vaccine by age 1 day and 50 percent had received it by age 3 days, CDC researchers report in Friday's Morbidity and Mortality Weekly Report, publication of the CDC.

Wide variations in vaccine coverage were seen between cities and states. Detroit, Michigan had the highest coverage at 77.5 percent, while Fresno County, California had the lowest at about 8 percent.

Infants infected with the hepatitis B virus have a 90 percent chance of becoming chronically infected, which can lead to cirrhosis and liver cancer, CDC researchers note.

Delivery hospitals play a key role in the national strategy to prevent hepatitis B transmission and should have policies and procedures in place to ensure that hepatitis B vaccination is administered to all newborns before they leave the hospital, they emphasize.

SOURCE: Morbidity and Mortality Weekly Report, August 1, 2008.