Stephen Friedman
1,
Alison E. Chi2, Shirley Huie
2, and Toby R. Keller
1. (1) Bureau of Immunization, New York City Department of Health and Mental Hygiene, 2 Lafayette Street, 19th floor - CN21, New York, NY, USA, (2) Citywide Immunization Registry, New York City Department of Health and Mental Hygiene, 2 Lafayette Street, 19th Floor, New York, NY, USA
BACKGROUND:
Following concern about thimerosal in vaccines, many hospitals stopped administering hepatitis B vaccine to newborns. This dose provides a safety net for neonatal hepatitis B prevention and increases likelihood of timely completion of three dose series. The NYS Department of Health and the NYC Department of Health and Mental Hygiene (NYCDOHMH) planned to offer hepatitis B vaccine for newborns if hospitals adopted a universal birth dose policy. Before implementing this offer, NYCDOHMH Bureau of Immunization (BOI) surveyed facilities to identify barriers to the birth dose.
OBJECTIVE:
To gather information from facilities about birth dose practice and determine whether free hepatitis B vaccine would motivate hospitals to routinely administer it to all newborns.
To determine if facilities are reporting administered birth doses to Citywide Immunization Registry (CIR), which helps BOI to monitor vaccine usage.
METHOD:
A five question survey was faxed to 46 NYC birth facilities and all responded, representing 122,937 births in 2002. Results were compiled in Excel and reporting responses were compared to CIR and Vital Records birth data.
RESULT:
21 facilities have a universal policy (33.5% of births). 5/25 facilities without current policy agreed to adopt one and accept vaccine. Top reasons for not adopting policy were pediatrician preference, use of combination vaccine, parental preference, and cost. Facilities that accepted the offer cited cost and pediatrician preference as reasons for not previously adopting universal policy.
14/21 facilities with universal policy reported a birth dose to the CIR for >90% of births.
CONCLUSION:
Vaccine cost, although a significant motivator, isn’t the exclusive reason for hospitals’ choice not to administer the birth dose.
Further investigation is needed to address issues preventing seven universal birth dose facilities from reporting for >50% of births.
LEARNING OBJECTIVES:
To understand issues preventing/motivating birth facilities to administer hepatitis B vaccine to newborns and report administered doses to an immunization registry.