BACKGROUND:
Failure of maternal hepatitis B testing to reach universal status, maternal testing “problems” that place exposed infants at risk of not receiving immunoprophylaxis, and the need to protect infants being discharged with occult HBAg(+) carriers prompted this project.

OBJECTIVE:
1) Assess Illinois birthing hospitals (IBHs) regarding hepatitis B vaccine for newborns prior to discharge and identify strategies for increasing birthdose vaccination.
2) Determine which IBHs are enrolled in the Vaccines for Children-Plus program.
3) Meet with five IBHs not administering the hepatitis B vaccine to discuss policy changes and related benefits.

METHOD:
In spring 2003, 132 IBHs received up to two written hepatitis B birthdose and VFC-Plus questionnaires. Follow-up calls to hospital staff urged completion of the questionnaires. Response rates of 72-74% were achieved. By spring 2004, meetings were held with key decisionmakers at five hospitals to discuss the benefits of administering the birthdose.

RESULT:
IBHs reported 41% have policies to administer the hepatitis B birthdose; 61% have written standing orders; 40% have both, and achieved an 88% birthdose immunization rate. For all IBHs, the estimated mean percent of infants receiving the birthdose in 2002 was 52%. Sixteen percent of respondents reported being enrolled in VFC-Plus and among those: 67% have policies to administer the birthdose; 87% have written standing orders; 67% have both, and achieved an 85% birthdose immunization rate. At enrolled hospitals the estimated mean percent of infants receiving the birthdose in 2002 was 81%.

CONCLUSION:
Establishment of hospital policies and written standing orders for hepatitis B vaccine at birth correlates with significantly higher immunization rates. Participation in the VFC-Plus program boosts birthdose immunization rates.

LEARNING OBJECTIVES:
1) Understand importance of hospital policies regarding universal administration of the hepatitis B vaccine at birth.
2) Examine correlation between VFC-Plus enrollment and higher hepatitis B birthdose rates.
3) Learn strategies to advocate for implementation of hospital policies regarding birthdose hepatitis B.