Published online January 4, 2006
PEDIATRICS Vol. 117 No. 1 January 2006, pp. 30-33 (doi:10.1542/peds.2005-0286)
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Hepatitis A

Factors Associated With Hepatitis A Vaccination Among Children 24 to 35 Months of Age: United States, 2003

Joseph J. Amon, PhD, MSPHa,b, Natalie Darling, MPHc, Anthony E. Fiore, MD, MPHb, Beth P. Bell, MD, MPHb and Lawrence E. Barker, PhDc

a Epidemic Intelligence Service, Epidemiology Program Office
b Division of Viral Hepatitis, National Center for Infectious Diseases
c National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia

OBJECTIVES. In 1999, the Advisory Committee on Immunization Practices made recommendations for hepatitis A vaccination of children according to historic rates of hepatitis A incidence in different regions of the country. The objective of this study was to examine hepatitis A vaccination coverage rates among children living in states with different vaccination recommendations and to examine individual characteristics associated with vaccination.

METHODS. Hepatitis A vaccination status data were collected for children 24 to 35 months of age through the National Immunization Survey, a telephone survey with health care provider-verified vaccination results. Vaccination status data were collected from children in each of the 50 states and 28 selected urban areas.

RESULTS. In 2003, 50.9% (95% confidence interval [CI]: 47.6–54.2%) of children living in 11 states where routine hepatitis A vaccination is recommended had received ≥1 dose, compared with 25.0% (95% CI: 21.8–28.2%) of children in 6 states where vaccination is suggested and 1.4% (95% CI: 1.0–1.8%) of children in 33 states without a recommendation. Coverage was higher among children who lived in urban areas, were Hispanic or American Indian/Alaska Native, or were born to women with less education.

CONCLUSIONS. Hepatitis A vaccination is being targeted successfully to children at higher risk of infection; however, overall vaccination coverage remains lower for hepatitis A vaccination, compared with other routine childhood vaccinations.

Key Words: hepatitis A • vaccination coverage • children • race/ethnicity • immunization policy

Abbreviations: ACIP—Advisory Committee on Immunization Practices • AIAN—American Indian/Alaska Native • CI—confidence interval • NIS—National Immunization Survey • OR—odds ratio

Accepted Mar 30, 2005.




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