KEYWORDS:
Hepatitis B, MMR, School Law

BACKGROUND:
California legislation requires 7th graders to have three doses of hepatitis-B vaccine (HBV) and two doses of measles containing vaccine. During fall of 1999, California conducted an assessment of 7th grade schools to determine compliance with the new legislation. Compliance rates for 3 doses of HBV were 68.6% and 2 doses of measles containing vaccine were 93.2%.

OBJECTIVE(S):
To determine the completion rates by ethnicity for both HBV and MMR in a cohort of children at 7th grade entry.

METHOD(S):
All HBV and MMR vaccinations dates were recorded for 100% of the enrolled children in a sample of thirty 7th grade schools. Additionally, ethnicity, zip code and birth-date were collected. Data were analyzed to determine completion status for HBV and MMR at various date and age milestones.

RESULT(S):
A total of 5103 records were analyzed. At school entry, 80% of the sample had 3 doses of HBV and 97% had 2 doses of MMR. Asian-Pacific Islanders had the highest completion rate for HBV (93%), followed by blacks (84%), whites (81%) and Hispanics (80%). Rates for MMR showed no appreciable racial differences. At the age 10 milestone, HBV completion rates were 28% overall. Completion rates were highest in blacks (44%), followed by Asian-Pacific Islanders (38%), Hispanics (25%) and whites (23%). At the age 11 milestone, HBV completion rates were again highest among blacks (48%), followed by Asian-Pacific Islanders (44%), Hispanics (33%) and whites (32%).

CONCLUSIONS(S):
Immunization coverage levels can be increased through implementation of school mandates. In the absence of school mandates, there is a disparity in completion rates between different races/ ethnicities.

LEARNING OBJECTIVES:
To determine the rates of hepatitis B and MMR coverage levels in adolescents and determine the impact of legislation requiring hepatitis B and MMR vaccination for 7th grade entry.