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Hepatitis B Series Best Begun at Birth

Kate Traynor

Newborns who receive their first hepatitis B vaccination soon after birth are more likely to complete the three-shot series than infants whose initial dose is given a week or more later, report scientists at the Centers for Disease Control and Prevention (CDC).

The scientists found that 96 percent of newborns who received their initial hepatitis B vaccination during the first week of life went on to complete the three-dose series. Infants given their first dose at eight to 41 days of age were 2.4 times less likely to get all three shots than those vaccinated earlier. 

The odds of completing the series decreased progressively with advancing age. Infants first vaccinated as 9-month-olds were 46.6 times less likely to get all three shots than newborns vaccinated during their first week. 

The study (PDF), which appeared in the Aug. 23/30 Journal of the American Medical Association, reported that approximately 87 percent of American children between 19 and 35 months of age in 1998 completed the hepatitis B series. Ninety-seven percent of children in the study received at least one dose, and over half of these initial vaccinations occurred during the first week of life. 

The study also examined whether early hepatitis B immunization increased compliance with the so-called 4:3:1:3 vaccination series, which consists of four doses of diphtheria and tetanus toxoids and acellular pertussis vaccine, three of poliovirus, one of measles, and three of Haemophilus influenzae type b. Children initially vaccinated against hepatitis B any time in their first 91 days of life were equally likely to complete the 4:3:1:3 series. Children given their first hepatitis B vaccination at 92 days of age or later were at least 1.7 times less likely to finish the 4:3:1:3 series than those vaccinated earlier. 

Study data was obtained from CDC’s 1998 National Immunization Survey (NIS), which sought vaccination information by telephone from 34,480 American households with children 19 to 35 months old. NIS follow-up included confirmatory written reports from the children’s health care providers. According to the article, complete telephone and written reports were obtained from about 70 percent of households sampled in 1998. 

When contacted for clarification about the sample size, lead author Hussain R. Yusuf, M.P.H., stated that 31,665 households with 32,511 eligible children completed the telephone survey. Confirmatory data was available for 21,518 children. Most of the study data, said Yusuf, came from the 20,881children in this group who received at least one hepatitis B vaccination.