PROGRESS TOWARD INTEGRATING HEPATITIS-B VACCINE INTO ROUTINE INFANT IMMUNIZATION SCHEDULES IN THE UNITED-STATES, 1991 THROUGH 1994

Objective. We assessed progress toward universal infant immunization a gainst hepatitis B, which was first recommended in November 1991. Meth ods. Multiple data sources were used to describe vaccination policies and trends in infant hepatitis B vaccine coverage. Results. As of June 1993, 51% of the 63 local, state, and territorial immunization progra ms recommended hepatitis B vaccination of all newborns shortly after b irth. The number of first dosages of hepatitis B vaccine administered to infants in public sector clinics increased rapidly from late 1992 t o 1993, and at the end of 1993 was approximately two thirds the number of first dosages of other infant antigens. In a nationwide survey of hospital nurseries 47% offered hepatitis B vaccine to all newborns. Of 3982 sampled newborns in these hospitals, 36.2% had been vaccinated b efore discharge. In San Francisco and Connecticut, where public health officials encouraged hospitals to offer hepatitis B vaccination, firs t-dose coverage at discharge was 82.3% in 1994 and 69.1% in 1993, resp ectively. Coverage was higher in healthier infants and lower in infant s of older or better-educated mothers. Results from the National Healt h Interview Survey demonstrate that three-dose completion at 12 months of age increased from less than 1% of children born in 1989 to 40% of children born in the fourth quarter of 1992, Vaccination at birth inc reased from less than 1% of infants born in 1989 to 32% of infants bor n in the second half of 1993. Conclusions. Infant hepatitis B vaccinat ion has expanded rapidly since national recommendations were made; how ever, universal coverage has not been achieved.