KEYWORDS:
Hepatitis B vaccination; Adults; National Health Interview Survey; Evaluation; Assessment

BACKGROUND:
The Advisory Committee on Immunization Practices (ACIP) recommends that high-risk adults receive the hepatitis B vaccine (HepB). For the first time in 2000, questions about hepatitis B vaccination among adults were included in the NHIS, which is the primary source for health information for the U.S. resident non-institutionalized population.

OBJECTIVE:
To estimate hepatitis B vaccination rates among adults by demographic, selected high-risk and other characteristics.

METHOD:
Hepatitis B vaccination coverage levels were determined using NHIS 2000 for all sampled adults by demographic, selected high-risk, and other characteristics. One “high-risk” question asks the respondent to answer yes if any of the following characteristics applied: hemophilia, men having sex with men, intravenous drug use, sex worker, HIV positive, or sex with anyone with these characteristics. The NHIS uses multistage cluster sampling. The data were weighted to ensure nationally representative results. Significant differences in coverage between groups were determined by chi-square and 95% confidence intervals.

RESULT:
Of 32,374 adults, 17% reported receiving 3 doses of HepB. Among health care workers the rate was 71%, among adults with one or more “high-risk” response(s), 25%, among those reporting ever having a sexually transmitted disease, 29%, and among those tested for HIV, 29%. Other statistically significant findings at p<0.01 indicating higher one or more dose vaccination rates were associated with self-perceived higher risk of getting HIV, female gender, under 35 years of age, non-Hispanic African-American, more education, married, more income, living with someone with hepatitis, exercising regularly, and visiting a health care provider within the last 2 years.

CONCLUSION:
Except for health care workers the rates of reported receipt of HepB are very low among those adults who identify themselves as in high-risk groups. Further analyses are needed to understand the factors associated with low hepatitis B vaccination rates among high-risk adults.

LEARNING OBJECTIVES:
The attendee will be able to describe self-reported hepatitis B vaccination levels among high-risk adults estimated from NHIS 2000.