Immunizing adolescents in private practice: Lessons learned from hepatitisB

Understanding factors associated with early adoption of the universal hepat itis B (HepB) immunization recommendation can guide efforts to improve rate s of adolescent immunization for emerging vaccines (eg, herpes simplex, hum an papilloma virus). A retrospective cohort and nested case-control design was used to determine factors associated with adolescent Hep B immunization in a managed care organization. In the year ater the new recommendation, 1 2.5% of the cohort received one or more Hep B immunizations. By logistic re gression, factors independently associated with immunization included havin g a primary care physician (PCP) specializing in pediatrics (adjusted odds ration [AOR] = 5.17; 95% confidence interval [Cl] = 2.51, 10.63); total num ber of PCP visits (AOR = 1.58; 95% Cl = 1.38, 1.81); and a preventive visit (AOR = 3.49; 95% Cl = 2.09, 5.83). Patient sex, household income, physicia n sex, and years since physician graduation from medical school were not in dependently associate with immunization.