Author information
1 Berry Technology Solutions, Inc., Peachtree City, GA, United States. Electronic address: carolyn.bridges@immunize.org.
2 IHRC, Inc., Atlanta, GA, United States. Electronic address: twatson@cdc.gov.
3 Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA, United States. Electronic address: nnelson@cdc.gov.
4 Communicable Disease Program, Chicago Department of Public Health, Chicago, IL, United States. Electronic address: maribel.chavez-torres@cityofchicago.org.
5 Division of Immunization, Michigan Department of Health & Human Services, Lansing, MI, United States. Electronic address: fineisp@michigan.gov.
6 Infectious Disease Prevention and Health Services Bureau, Prevention and Health Promotion Administration, Maryland Department of Health, Baltimore, MD, United States. Electronic address: boatemaa.ntiri-reid@maryland.gov.
7 Immunization Services Division, NCIRD, CDC and Adult Immunization Unit, New York City Department of Health and Mental Hygiene, New York, NY, United States. Electronic address: ewake@health.nyc.gov.
8 Public Health Division, Oregon Health Authority, Portland, OR, United States. Electronic address: Judith.m.leahy@state.or.us.
9 San Antonio Metropolitan Health District, San Antonio, TX, United States. Electronic address: anita.kurian@sanantonio.gov.
10 Cherokee Nation Assurance, Atlanta, GA, United States. Electronic address: nmp8@cdc.gov.
11 Immunization Services Division, NCIRD, CDC, Atlanta, GA, United States. Electronic address: edkennedy@cdc.gov.
Abstract
BACKGROUND:
Acute hepatitis B virus (HBV) infections in the United States occur predominantly among persons aged 30-59?years. The Centers for Disease Control and Prevention (CDC) recommends vaccination of adults at increased risk for HBV infection. Completing the hepatitis B (HepB) vaccine dose-series is critical for optimal immune response.
OBJECTIVES:
CDC funded 14 health departments (awardees) from 2012 to 2015 to implement a pilot HepB vaccination program for high-risk adults. We evaluated the pilot program to assess vaccine utilization; vaccine dose-series completion, including by vaccination location type; and implementation challenges.
METHODS:
Awardees collaborated with sites providing health care to persons at increased risk for HBV infection. Awardees collected information on doses administered, vaccine dose-series completion, and challenges completing and tracking vaccinations, including use of immunization information systems (IIS). Data were reported by each awardee in aggregate to CDC.
RESULTS:
Six of 14 awardees administered 47,911 doses and were able to report patient-level dose-series completion. Among persons who received dose 1, 40.4% received dose 2, and 22.3% received dose 3. Local health department clinics had the highest 3-dose-series completion, 60.6% (531/876), followed by federally qualified health centers at 38.0% (923/2432). While sexually transmitted diseases (STD) clinics administered the most doses in total (17,173 [35.8% of 47,911 doses]), 3-dose-series completion was low (17.1%). The 14 awardees reported challenges regarding completing and tracking dose-series, including reaching high-risk adults for follow-up and inconsistencies in use of IIS or other tracking systems across sites.
CONCLUSIONS:
Dose-series completion was low in all settings, but lowest where patients may be less likely to return for follow-up (e.g., STD clinics). Routinely assessing HepB vaccination needs of high-risk adults, including through use of IIS where available, may facilitate HepB vaccine dose-series completion.