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PEDIATRICS Vol. 112 No. 4 October 2003, pp. e269-e269

ELECTRONIC ARTICLE

Parental Knowledge, Attitudes, and Practices Associated With Not Receiving Hepatitis A Vaccine in a Demonstration Project in Butte County, California

Barbara Bardenheier, MPH, MA*, Idalia M. González, MD, MPH*, Michael L. Washington, PhD{ddagger}, Beth P. Bell, MD, MPH§, Francisco Averhoff, MD, MPH*, Mehran S. Massoudi, PhD, MPH*, Insu Hyams, BSRN||, Edgar P. Simard, BS§, Hussain Yusuf, MBBS, MPH*

* Immunization Services Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia
{ddagger} Data Management Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia
§ Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
|| Butte County Department of Public Health, Oroville, California

Objective. To determine hepatitis A vaccination coverage and factors associated with not receiving hepatitis A vaccine among children.

Methods. A random cluster sample survey was conducted of parents of children who attended kindergarten in Butte County, California, in 2000. Because of a history of recurrent epidemics, an aggressive hepatitis A vaccination program was ongoing during the time this study was conducted. Receipt of 1 or 2 doses of hepatitis A vaccine was studied.

Results. Of 896 surveys sent, 648 (72%) were completed. The vaccination coverage for at least 1 dose of hepatitis A vaccine was 398 (62%) and for 2 doses was 272 (42%). Factors associated with not receiving the vaccine included lack of provider recommendation (vs having recommendation; odds ratio [OR]: 7.8; 95% confidence interval [CI]: 4.9–12.2), not having heard of the vaccine (OR: 2.4; 95% CI: 1.2–4.9), and parent’s not perceiving child is likely to get hepatitis A (vs perceiving child might get disease; OR: 2.1; CI: 1.6–2.9).

Conclusions. Vaccination coverage among kindergartners did not reach high levels (ie, >90%), despite aggressive vaccination efforts in this community. Lack of provider recommendation and lack of parental awareness of hepatitis A vaccine were the 2 most significant factors associated with failure to receive vaccine. These findings will facilitate the development of vaccination strategies for communities in which hepatitis A vaccination is recommended.

Key Words: hepatitis A; knowledge • attitudes • and practices; vaccination

Abbreviations: CDC, Centers for Disease Control and Prevention • ACIP, Advisory Committee on Immunization Practices • BCHD, Butte County Health Department • CI, confidence interval • SES, socioeconomic status

Received for publication Oct 21, 2002; Accepted May 19, 2003.


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