KEYWORDS:
Hepatitis B, Advisory Committee on Immunization Practices (ACIP), birth dose, perinatal

BACKGROUND:
At the National Hepatitis Coordinators' Conference in August 2001, attendees participated in a panel discussion about the birth dose of hepatitis B vaccine. Participants expressed concern about the ACIP recommendation that stated hepatitis B vaccine could be given to infants of HBsAg-negative mothers as late as two months of age. Many expressed concerns that this increased the likelihood of at-risk babies not receiving necessary postexposure prophylaxis at birth.

OBJECTIVE(S):
As a result of this discussion, the Immunization Action Coalition designed a "Hepatitis B Vaccine Birth Dose Survey" and distributed it to all state hepatitis B coordinators, directors of 11 federally-funded local hepatitis B programs, and the hepatitis B coordinators of the eight U.S. territories.

METHOD(S):
The survey was e-mailed or faxed to all hepatitis coordinators.

RESULT(S):
Coordinators from all 50 states as well as from 9 city, county, and territory projects completed the survey in early October 2001. Their responses included over 200 examples of children who were unprotected or inadequately protected due to errors in not ordering, misordering, misinterpreting, mistranscribing, or miscommunicating hepatitis B test results. In order to prevent these failures, the states unanimously endorsed recommending a universal birth dose.

CONCLUSIONS(S):
The Immunization Action Coalition shared these survey results with members of the Advisory Committee on Immunization Practices (ACIP) before their October 2001 meeting. On October 17, 2001, the ACIP voted to recommend a birth dose of hepatitis B vaccine for all infants, which means that the first dose of hepatitis B vaccine should be administered between birth and hospital discharge.

LEARNING OBJECTIVES:
Understand why the first dose of hepatitis B vaccine is recommended for all babies at birth.