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Learning Objective:
By the end of the presentation participants will:
- Understand issues around implementing a hepatitis B birth dose policy
- Understand reasons some providers are opposed to the birth dose.
Background:
Following the July 1999 temporary suspension of routine hepatitis B vaccine for infants born to HBsAg negative women, birthing hospitals in New York State (NYS) were slow to reinstate a universal hepatitis B birth dose policy (UHBBDP) even though this was recommended by ACIP in December 1999. A 2001 survey of upstate hospitals revealed that only 18% had a UHBBDP. Cost of vaccine was one of the barriers identified in the failure to adopt a UHBBDP.
Setting:
Birthing hospitals
Population e.g. API Youth, MSM, IDU:
Infants born in NYS
Project Description:
In December 2003, the NYS and New York City (NYC) DOH Immunization Programs began providing free hepatitis B vaccine to all birthing hospitals that adopt a UHBBDP. As of May 2005, 60 out of 110 upstate hospitals and 31 out of 47 New York City hospitals have enrolled in the initiative, representing about 60% of annual births in the state. Outreach to hospitals that did not enroll was conducted to identify reasons for not adopting a UHBBDP.
Results/Lessons Learned:
The informal survey of non-enrolled hospitals reveals failure to adopt a UHBBDP is primarily due to physician resistance due to several reasons including: desire to administer the first dose in the office setting, which has a financial incentive, misconception that 4 doses is too many if combination vaccines are used for follow up doses, and lack of understanding about the importance of the birth dose as a "safety net" to prevent early childhood transmission. All NYC public hospitals had a UHBBDP. Based on the results, outreach and education will be targeted to non-enrolled hospitals.
See more of D1 - Addressing the Challenges to Ensuring a Birth Dose of Hepatitis B Vaccine
See more of The 2005 National Viral Hepatitis Prevention Conference