Cdc's Adult Hepatitis B Vaccination Initiative

Background: Since 1991, routine infant and adolescent vaccination has resulted in reductions in HBV incidence among children and adolescents in the United States. However, vaccination rates among at-risk adults have not kept pace. Of the estimated 43,000 new HBV infections in 2007, the highest incidence rates occurred among adults, a high proportion of whom engaged in high-risk sexual activity and/or injection drug use. To address this low vaccination coverage, the Advisory Committee on Immunization Practices recommended that universal hepatitis B vaccination be offered at no cost in settings that provide services to adults at risk for HBV infections. In September 2007, CDC launched the Adult Hepatitis B Vaccination Initiative to improve hepatitis B coverage. 

Objectives: To evaluate the vaccination strategies for US jurisdictions administering doses of hepatitis B vaccine.

Methods: Data from November 1, 2007 – June 30, 2009 were analyzed for all jurisdictions.  To assess change in vaccine administration, data for one jurisdiction were compared to the previous 2-year time period.

Results: Nationwide, 56 CDC-supported programs administered 448,178 doses of hepatitis B containing vaccine to at-risk adults in 1,212 settings (e.g., STD clinics, HIV testing and treatment facilities, correctional facilities).  Nationally, five of the 56 jurisdictions administered 52% or 235,176 doses of hepatitis B vaccine to adults in 255 settings.  Among the five, 78% of the doses (133,937) were administered in local health departments and 58% of the doses (71,335) in STD clinics.  For one of the five jurisdictions, an increase of 34% was found in dose administration.

Conclusions: These results demonstrate that when vaccine was supplied at no cost, settings serving at-risk adults were able to administer vaccine as part of their existing clinical activities.  Because a sizable increase in vaccine administration was found in one jurisdiction, similar increases are expected in other high volume areas.