Hepatitis B Vaccine: Illinois Birthing Hospitals Birth Dose Practices

Learning Objectives for this Presentation:
By the end of the presentation participants will be able to:
1. Understand importance of hospital policies regarding universal administration of hepatitis B vaccine at birth.
2. Examine correlations between written policies, standing orders, and prophylaxis management of birthdose policies.
3. Compare state versus national birthdose administration practices

Background:
The 1999 thimerosal scare posed a critical setback to universal implementation of hepatitis b birthdose. Despite availability of thimerosal-free vaccine and AAP recommendations, universal birthdose vaccination hasn't been reached, and many hospitals don't routinely administer hepatitis B vaccine to all newborns prior to hospital discharge. Evidence suggests without birthdose, infants face greater risk of exposure to hepatitis B virus and are not as likely to complete the vaccination series.

Objectives:
1. Survey Illinois birthing hospitals' (IBHs) regarding prophylaxis management of hepatitis B vaccine for newborns prior to discharge.
2. Compare 2003 and 2007 survey findings; contrast findings with national survey results.
3. Coordinate hospital meetings to discuss policy changes and barriers to implementation of birthdose.

Methods:
In early 2007, surveys were sent to 108 IBHs. Three rounds of surveys were mailed to individuals deemed appropriate to contact for survey completion. For comparison purposes, questions on policies/practices related to perinatal HIV were included.

Results:
Basic neonatal care level hospitals less likely to report written policies and standing orders on vaccine administration within 12 hours of birth for infants of mothers with unknown status than higher level hospitals. More likely to report written policies and standing orders for newborns prior to discharge compared to higher level neonatal care hospitals .
Nurses more likely to report written policies and standing orders for vaccine administration to all newborns before hospital discharge.

Conclusions:
Illinois respondents more likely to report review and test policies versus hospitals nationally. Illinois hospitals behind national hospitals in prophylaxis management of birthdose vaccine.