Hepatitis B Vaccination Coverage Among High-Risk Adults Aged 18-49 Years, U.S., 2008

Background: Approximately 43,000 new hepatitis B virus (HBV) infections occurred in 2007 with the highest rates occurring among 25-44 year olds. Hepatitis B vaccination is recommended for all adults at risk of HBV infection.  In 2004, it was estimated that 45% of high-risk adults were vaccinated against HBV.

Objectives: To assess HBV vaccination coverage among persons aged 18-49 years who have risks for HBV infection.

Methods: We estimated prevalence of self-reported receipt of hepatitis B vaccine in adults aged 18–49 years using the 2008 National Health Interview Survey. Weighted proportions of persons who received ≥1 doses of vaccine were calculated by risk level (high versus low risk) and other risk characteristics. Adults were considered to be high-risk if one or more of the following applied: male sex with men; injection drug use; hemophilia with receipt of clotting factors; sexually transmitted disease in prior five years; had sex for money or drugs; HIV positive; sex with any of the above; or respondent felt they were at high risk for HIV.

Results: The proportion of high-risk 18-49 year olds who received ≥1 doses of hepatitis B vaccine and the complete 3-dose series was 46% (95% CI=43–51%) and 36% (32–40%) compared to 40% (37–41%) and 34% (33–36%) in low risk adults, respectively.  Vaccination coverage was higher among females, persons ever tested for HIV and health care workers, regardless of risk level.  Vaccination coverage significantly decreased as age increased (≥1 doses:  62% (57—67%) versus 30% (27—31%) in all 18-20 and 41-49 year olds, respectively.

Conclusions: High-risk 18-49 year olds have a higher prevalence of hepatitis B vaccination than adults who do not report risk factors for HBV infection. The proportion of vaccinated high-risk adults, however, has not changed substantially since 2004. To improve vaccination coverage, healthcare providers should ensure that high-risk adults are offered vaccination.  Key Words: hepatitis B vaccine, vaccination, coverage, adult, high-risk