Hepatitis B vaccination coverage among United States children

Background. In 1991 the Advisory Committee on Immunization Practices recomm ended vaccination of all infants with three doses of hepatitis B virus vacc ine (HepB) by 18 months of age as a key component of a comprehensive strate gy to eliminate hepatitis B virus transmission in the United States. The Am erican Academy of Pediatrics and the American Academy of Family Physicians published similar recommendations soon afterward. Methods. Data were obtained from the National Immunization Survey, a survey that began in 1994 and is conducted quarterly by the Centers for Disease C ontrol and Prevention to estimate vaccination coverage among noninstitution alized US children 19 to 35 months of age. Results. The 1999 National Immunization Survey data indicate that similar t o 88.1% (95% confidence interval, 87.4, 88.8) of children 19 to 35 months o f age had received at least three doses of HepB (HepB3). There has been a c onsistent increase in HepB3 coverage since 1994. However, the rate of incre ase has slowed in recent years and HepB3 coverage remains lower than covera ge attained with three doses of diphtheria-tetanus-pertussis and Haemophilu s influenzae vaccines. HepB3 coverage varied slightly by race/ethnicity and was highest among white and Asian children (89%). Coverage also varied by state; 26 states had levels of at least 90%. Conclusions. Since the 1991 recommendations for universal hepatitis B vacci nation, there has been a dramatic increase in coverage levels among childre n 19 to 35 months of age. However, the Childhood Immunization Initiative go al of 90% coverage has not been reached. Therefore continued efforts are ne eded to protect US children against this serious but preventable infection.