BACKGROUND: Hepatitis B virus (HBV) is a bloodborne pathogen and can be transmitted through sexual contact, injection drug use, or perinatally. West Virginia has the highest HBV infection rate in the United States, and it has increased since 2010. An effective vaccine is available to prevent HBV infection; the first dose is recommended at birth. We sought to identify maternal and birth-event factors associated with Hepatitis B (HepB) vaccine birth-dose receipt.
METHODS: We matched immunization registry records with West Virginia vital records for live births in 2015. The dependent variable was timely HepB vaccine birth-dose receipt (i.e. <3 days postdelivery). We performed multivariate logistic regression analysis by using SAS® 9.3 and calculated adjusted odds ratios (AORs) and 95% confidence intervals (CIs).
RESULTS: We matched 17,458 (99.8%) immunization records to vital records. Birth-dose receipt was timely for 14,006 (80.2%) newborns. Factors associated with timely receipt included hospital (versus nonhospital) birth (AOR: 14.95; CI: 9.63–23.43), medical (versus nonmedical) birth attendant certification (AOR: 1.68; CI: 1.42–1.98), weekday (versus weekend) birth (AOR: 1.16; CI: 1.05–1.29), maternal age <35 years (AOR: 1.26; CI: 1.11–1.43), and breastfeeding (AOR: 1.25; CI: 1.15–1.36). Medicaid (versus any other or none) as primary insurance type (AOR 0.86; CI: 0.79–0.94) and white (versus any other) race (AOR: 0.75; CI: 0.64–0.89) were negatively associated with timely receipt.
CONCLUSIONS: We identified maternal and birth-event factors associated with HepB birth-dose receipt. Identification of specific barriers (such as HepB vaccination recommendation knowledge deficit) to timely receipt for mothers who are ≥35 years, white, and use Medicaid, particularly in nonhospital birth settings or with nonmedical birth attendants are needed to improve vaccine-related HBV prevention.