Newborn Hepatitis B Vaccination Coverage Among Children Aged 3, 5, and 19-35 Months— Immunization Information System Sentinel Sites, United States, 2008–2009

Background: CDC’s Advisory Committee on Immunization Practices (ACIP) recommends that all medically stable newborns who weigh ≥2,000 g (4.4 lbs) receive their first dose of Hepatitis B vaccine before hospital discharge. In 2008, the National Immunization Survey (NIS) estimated that  55.3% (±1.3)% of 19-35 month old children had 1 dose of Hepatitis B vaccine administered between birth and age 3 days.

Objectives: Describe administration of the birth dose of Hepatitis B vaccine between date of birth and age 2 days among children aged 3, 5, and 19-35 months.

Methods: We utilized aggregate quarterly data from eight Immunization Information Systems (IIS) participating in CDC’s IIS Sentinel Site Project from 2008–2009. Using unweighted averages of each site’s data, we examined administration of the Hepatitis B birth dose on the date of birth, age 1 day, 2 days, and by 2 days for children 3, 5, and 19-35 months of age. Using 2009 data, we also examined administration by age 5 days for these age groups. 

Results: Among IIS sentinel sites, 48.5% of 19-35 month olds had received a birth dose of Hepatitis B by age 2 days in 2008 and increased to 54.7% in 2009.  Of 3 and 5 month olds, approximately 60% received the birth dose by age 2 days in both 2008 and 2009. By age 5 days, the birth dose vaccination coverage increased by only an average of 2 percentage points in 2009 in the age groups we examined. Of those children who received the birth dose by age 2 days, approximately 50% received it on their birth date.

Conclusions: Receipt of the birth dose by age 2 days is comparable to NIS estimates at age 3 days. Examining coverage at age 5 days does not increase coverage significantly. Although adherence to the ACIP recommendations is high, there remains room for improvement.