Highlights
- •Delays in childhood vaccinations may be able to be traced back to birth.
- •In this study,fewer than 50% of babies who missed the birth dose of hepatitis B vaccine were fully vaccinated at age 2.
- •It is important to develop patterns of timely vaccination to prevent serious downstream consequences.
- •Medical providers should start talking with parents about childhood vaccinations long before a woman becomes pregnant.
Summary
Objectives
To determine whether missing the HepB birth dose vaccine is a risk factor for incomplete
vaccination later in childhood.
Methods
This was a retrospective cohort study of infants born over one year at an academic
medical center. The “not vaccinated at birth” group consisted of all infants who did
not receive the HepB birth dose vaccine by seven days of life, while the “vaccinated
at birth” group included infants who did receive the birth dose. The primary outcome
was vaccination status at 18 months of age, determined from the state vaccination
registry.
Results
Infants “not vaccinated at birth” had lower vaccination rates. At 18 months, 44% of
the “vaccinated at birth” group received all recommended vaccines, compared with 23%
of the “not vaccinated at birth” group (p < 0.001); at 24 months, rates were 65% and 45%, respectively (p < 0.001). Over 80% of the variability in vaccination completions were related to
a single latent variable, which is most likely vaccine hesitancy/refusal.
Conclusions
Infants who miss the HepB birth dose vaccine are at risk for under-immunization by
18 and 24 months of age. This suggests that parents likely form opinions about vaccines
long before the birth of their child; therefore, efforts to influence attitudes must
begin earlier.
Graphical abstract
Graphical Abstract
Keywords
Abbreviations:
AAP (American Academy of Pediatrics), ACIP (Advisory Committee on Immunization Practices), CDC (Centers for Disease Control and Prevention), DTaP (Diphtheria, Tetanus & acellular Pertussis), HepB (Hepatitis B Virus), Hib (Haemophilus influenza type b), IPV (Inactivated Poliovirus), MMR (Measles, Mumps and Rubella), NCIR (North Carolina Immunization Registry), NV (“not vaccinated at birth”), PCV13 (Pneumococcal Conjugate), RV (Rotavirus), VAR (Varicella), YV (“vaccinated at birth”)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 04, 2018
Accepted:
September 28,
2018
Received in revised form:
September 24,
2018
Received:
June 20,
2018
Identification
Copyright
© 2018 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
