Missed Opportunities for Hepatitis A Vaccination, National Immunization Survey-Child, 2013

• Published in: The Journal of pediatrics 2017-08, Vol.187, p.265-271.e1
• Main Authors: Casillas, Shannon M., MPH, Bednarczyk, Robert A., PhD
• Format: Article
• Language: English
• Subjects: Child; Child, Preschool; children; Cross-Sectional Studies; Female; hepatitis A; Hepatitis A - prevention & control; Humans; immunization; Immunization Programs - statistics & numerical data; Infant; Male; missed opportunities; National Immunization Survey Child; NIS-Child; Pediatrics; primary care; Surveys and Questionnaires; United States; vaccination; Viral Hepatitis Vaccines - administration & dosage
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2017.04.001

Objectives To quantify the number of missed opportunities for vaccination with hepatitis A vaccine in children and assess the association of missed opportunities for hepatitis A vaccination with covariates of interest. Study design Weighted data from the 2013 National Immunization Survey of US children aged 19-35 months were used. Analysis was restricted to children with provider-verified vaccination history (n = 13 460). Missed opportunities for vaccination were quantified by determining the number of medical visits a child made when another vaccine was administered during eligibility for hepatitis A vaccine, but hepatitis A vaccine was not administered. Cross-sectional bivariate and multivariate polytomous logistic regression were used to assess the association of missed opportunities for vaccination with child and maternal demographic, socioeconomic, and geographic covariates. Results In 2013, 85% of children in our study population had initiated the hepatitis A vaccine series, and 60% received 2 or more doses. Children who received zero doses of hepatitis A vaccine had an average of 1.77 missed opportunities for vaccination compared with 0.43 missed opportunities for vaccination in those receiving 2 doses. Children with 2 or more missed opportunities for vaccination initiated the vaccine series 6 months later than children without missed opportunities. In the fully adjusted multivariate model, children who were younger, had ever received WIC benefits, or lived in a state with childcare entry mandates were at a reduced odds for 2 or more missed opportunities for vaccination; children living in the Northeast census region were at an increased odds. Conclusions Missed opportunities for vaccination likely contribute to the poor coverage for hepatitis A vaccination in children; it is important to understand why children are not receiving the vaccine when eligible.