KEYWORDS:
hepatitis B, birth dose, perinatal

BACKGROUND:
In September 2001, the Immunization Action Coalition, with help from the Centers for Disease Control and Prevention, distributed a "Hepatitis B Vaccine Birth Dose Survey" to determine the views of state and local hepatitis B coordinators about the timing of the first dose of hepatitis B vaccine. Respondents provided over 200 examples of children who were unprotected or inadequately protected due to various provider errors. In October 2002, the Coalition distributed a follow-up survey, specifically requesting feedback on the impact of the January 2002 ACIP recommendation.

OBJECTIVE:
To determine current views and practices regarding the first dose of hepatitis B vaccine, especially in light of the revised ACIP recommendation, January 2002, stating a preference for the birth dose.

METHOD:
A questionnaire was emailed or faxed to each of the 56 federally funded state and metropolitan hepatitis B coordinators in October 2002.

RESULT:
Coordinators from all 50 states and 6 local projects completed the 2002 survey. Opinion was divided as to whether the ACIP recommendation had an impact in their area. For this one year period, they provided over 375 examples of babies born to HBsAg-positive mother who were not properly prophylaxed within 12 hours of birth, babies born to mothers of unknown HBsAg status who did not receive hepatitis B vaccine within 12 hours of birth, and babies whose mothers' lab tests were wrongly ordered, misinterpreted, or mistranscribed.

CONCLUSION:
Many infants remain at risk for perinatal hepatitis B infection due to improperly followed recommendations.

LEARNING OBJECTIVES:
1) Learn the different types of errors being made in maternal screening and perinatal hepatitis B post-exposure prophylaxis.
2) Understand why maternal screening alone will not eliminate all failures to properly protect newborns against hepatitis B infection.