Association between administration of hepatitis B vaccine at birth and completion of the hepatitis B and 4 : 3 : 1 : 3 vaccine series

Context The association between infant age at initiation of hepatitis B vac cination and completion of the 3-dose hepatitis B vaccination series is unc lear. Objective To assess the association between administration of the first dos e of hepatitis B vaccine within 7 days of birth and completion of the hepat itis B vaccine series and the 4:3:1:3 vaccine series (4 doses of diphtheria -tetanus-pertussis vaccine, 3 doses of polio vaccine, 1 dose of measles-con taining vaccine, and 3 doses of Haemophilus influenzae type b vaccine). Design, Setting, and Participants Analysis of data from the 1998 National I mmunization Survey, a random-digit-dialing telephone survey (n=34480 comple ted interviews) of parents of children aged 19 to 35 months from 50 states and 28 selected urban areas in the United States that included a provider r ecord check mail survey. Main Outcome Measures Percentage of infants who received at least 3 doses o f hepatitis B vaccine and percentage who received the 4:3:1:3 vaccine serie s, by age at receipt of the first dose of hepatitis B vaccine. Results Overall, 86.9% of children 19 to 35 months of age in 1998 received 3 or more doses of hepatitis B vaccine, and 79.9% completed the 4:3:1:3 vac cine series. Multivariate analysis indicated that, compared with children w ho received the first hepatitis B vaccine dose within 7 days of birth, odds ratios (ORs) for not completing the 3-dose hepatitis B vaccine series amon g children who received the first dose at 8 to 41 days, 42 to 91 days, 92 t o 182 days, 183 to 273 days, and 274 or more days of age were 2.4 (95% conf idence interval [CI], 2.0-3.0), 7.8 (95% CI, 6.5-9.3), 9.6 (95% ci, 7.0-13. 3), 18.3 (95% CI, 12.0-28.0), and 46.6 (95% CI, 33.7-64.5), respectively; O Rs for not completing the 4:3:1:3 vaccine series among these same groups we re 1.0 (95% CI, 0.8-1.1), 1.0 (95% CI, 0.8-1.1), 1.7 (95% CI, 1.3-2.3), 3.8 (95% CI, 2.6-5.6), and 4.0 (95% CI, 2.9-5.5), respectively. Conclusion Administration of the first dose of hepatitis 3 vaccine at birth is associated with increased likelihood of completion of the hepatitis 8 v accination series.