UNIVERSAL HEPATITIS-B VACCINATION - HOSPITAL FACTORS INFLUENCING FIRST-DOSE UPTAKE FOR NEONATES IN DARWIN

A universal neonatal hepatitis B vaccination program was introduced in the Northern Territory in 1990. We compared live births with vaccine usage to determine the uptake of the first dose of hepatitis B vaccine under this new policy and to identify hospital factors that influence d this rate. Attitudes and vaccine administration practices were deter mined through interviews, using standard questions with midwifery and paediatric nursing staff at both hospitals. Hepatitis B vaccines dispe nsed at Hospital A indicated a 96 per cent coverage of neonates in 199 3 and 93 per cent in 1994. Vaccination at Hospital B indicated 71 per cent coverage in 1993 and 77 per cent in 1994. Differences in vaccine uptake appeared to be influenced by the use of standing drug orders, t he nursing staffs attitudes and knowledge, and misinformation among he alth professionals. Education programs for health professionals and pa rents need to be established before the introduction of a universal he patitis B vaccination policy for it to be well accepted. Standing orde rs for hepatitis B vaccine in postnatal wards allow nursing staff to p romote it and thus maximise coverage rates.