Hepatitis B immunization coverage among Vietnamese-American children 3 to 18 years old

Objective. Persons with chronic hepatitis B virus (HBV) infection are at in creased risk of chronic hepatitis, cirrhosis, and liver cancer. Although HB V infection is relatively uncommon in the United States, the disease is end emic in persons born in Southeast Asia, including Vietnamese-Americans. Cur rent US infant immunization recommendations and state-mandated school-entry programs have left many nontargeted age-cohorts unvaccinated and at risk o f infection. To assess the need for catch-up hepatitis B immunizations, thi s study reports the hepatitis B immunization rates of Vietnamese-American c hildren 3 to 18 years old living in the metropolitan areas of Houston and D allas, Texas, and the Washington, DC, area. Design. We conducted 1508 telephone interviews with random samples of Vietn amese households in each of the 3 study sites. We asked for hepatitis B imm unization dates for a randomly selected child in each household. Attempts w ere made to verify immunization dates through direct contact with each chil d's providers. Low and high estimates of coverage were calculated using rep orts from providers when reached (n = 720) and for the entire sample (n = 1 508). Results. Rates of having 3 hepatitis B vaccinations ranged from 13.6% (enti re sample) to 24.1% (provider reports, Dallas), 10.3% to 26.4% (Houston), a nd 18.1% to 37.8% (Washington, DC). Children living in the Texas sites, old er children, children whose families had lived in the United States for a l onger time, and children whose provider was Vietnamese or who had an instit utional provider were less likely to have been immunized. The odds of being immunized were greater, however, for children who had had at least 1 dipht heria, tetanus toxoid, and pertussis shot, and whose parents had heard abou t HBV infection, and were married. Conclusions. The low rates of hepatitis B vaccine coverage among children a nd adolescents portend a generation which, too old to benefit from infant p rograms and school entry laws, will grow into adulthood without the protect ion of immunization. Increased efforts are needed to design successful catc h-up campaigns for this population.