Trends in Hepatitis B (HepB) Birth Dose Vaccination Coverage by Annual Birth Cohorts, 1999-2007, National Immunization Survey (NIS)

Background: Trends in HepB birth dose coverage by annual birth cohort have not been studied. These data are important for evaluating the impact of the universal birth dose recommendation of ACIP in 2005.

Objectives: To evaluate trends by annual birth cohort in HepB birth dose coverage for the US and by race/ethnicity, poverty and education level for 1999-2007; to compare HepB birth dose coverage between the 2005 and 2006 birth cohorts nationally and by state.

Methods: HepB birth dose was defined as receiving the 1^st dose by 2 days of age.   NIS data from 2000-2008 were combined to provide estimates for 1999-2007 annual birth cohorts. T-tests were applied to compare the HepB birth dose coverage across birth years/strata, and weighted linear regressions were used to test the linear trends. Data analyses were performed with SUDAAN software.

Results: HepB birth dose coverage increased over the birth cohort years 1999-2007 in the US, from 32.0% in 1999 to 63.0% in 2007, with an average annual birth percentage increase of 3.4% (significant linear trend, p-value<0.01). Similar significant coverage increases and linear trends were observed for all demographic strata. The most significant increases between year birth cohorts were from 2000 to 2001 and from 2005 to 2006. National coverage for each time period increased 10.1% (p-value< 0.01) and 6.0% (p-value<0.01), respectively. Increases ranged from 4.63% to 11.5% across demographic strata. The national HepB birth dose coverage for the 2006 birth cohort (56.1%) was significantly higher than the 2005 cohort (50.1%) (p-value<0.01). A total of 38 states had higher coverage in 2006 than in 2005; the increase was statistically significant in 10 of the 38 states (p-value<0.05).

Conclusions: The 2005 ACIP universal birth dose recommendation was associated with an increase in HepB birth dose coverage.