Biomedical subjects

Pascale M Wortley

Publications and source records attributed to Pascale M Wortley.

18 recordsLinked to original sources

PubMed2006

Programmatic factors related to smallpox vaccine uptake by healthcare workers and others.

We surveyed program coordinators at 106 hospitals and health departments that participated in the National Smallpox Vaccination Program to ascertain how program-level factors affected the rate of smallpox vaccine uptake by staff. In a fully adjusted multivariate model, health departments achieved significantly higher vaccination rates than did hospitals, as did facilities that invited fewer employees to be vaccinated.

Attitude of Health Personnel↗

PubMed2006

The role of attitudes in understanding disparities in adult influenza vaccination.

BACKGROUND: Racial/ethnic disparities in influenza vaccine coverage of adults aged 65 years and older persist even after controlling for access, healthcare utilization, and socioeconomic status. Differences in attitudes toward vaccination may help explain these disparities. The purpose of this study was to describe patient characteristics and attitudes toward influenza vaccination among whites and African Americans aged 65 years and older, and to examine their effect on racial disparities in vaccination coverage. METHODS: A cross-sectional telephone survey of Medicare beneficiaries in five U.S. sites, sampled on race/ethnicity and ZIP code. Multivariate analysis controlling for demographics, healthcare utilization, and attitudes toward influenza vaccination was conducted in 2005 to assess racial disparities in vaccine coverage during the 2003-2004 season. RESULTS: The analysis included 1859 white and 1685 African-American respondents; 79% of whites versus 50% of African Americans reported influenza vaccination in the past year (p < 0.00001). Both vaccinated and unvaccinated African Americans were significantly less likely than whites to report positive attitudes toward influenza vaccination. Even among respondents with provider recommendations, respondents with positive attitudes were more likely to be vaccinated than those with negative attitudes. After multivariate adjustment, African Americans had significantly lower odds of influenza vaccination than whites (odds ratio = 0.55, 95% confidence interval = 0.42-0.72). CONCLUSIONS: A significant gap in vaccination coverage between African Americans and whites persisted even after controlling for specific respondent attitudes. Future research should focus on other factors such as vaccine-seeking behavior.

Aged↗

PubMed2006

Racial and ethnic disparities in influenza vaccination coverage among adults during the 2004-2005 season.

During the 2004-2005 influenza season, the supply of vaccine to the United States was significantly reduced. In response, the Centers for Disease Control and Prevention and the Advisory Committee on Immunization Practices issued interim recommendations for prioritizing vaccination. Given trends in racial/ethnic disparities in vaccination for influenza, the authors assessed the impact of the shortage on those historically less likely to be vaccinated. Using data from the Behavioral Risk Factor Surveillance System, they considered vaccination coverage among those non-Hispanic Whites, non-Hispanic Blacks, and Hispanics who had priority for being vaccinated during the 2004-2005 influenza season. The vaccine shortage had a significant negative effect on coverage among adults aged 65 years or older across the three racial/ethnic groups. Yet, the magnitude of the disparities in coverage did not change significantly from previous seasons. This finding may imply similar patterns of vaccine-seeking behavior during shortage and nonshortage years. No racial/ethnic differences were seen among adults aged 18-64 years, which likely reflects the higher percentage of health-care workers in this age group. Yearly monitoring of influenza vaccine coverage is important to assess the long-term impact of shortages on overall coverage and gaps in coverage between racial/ethnic groups.

Adult↗

PubMed2006

Influenza vaccination status and influenza-related perspectives and practices among US physicians.

BACKGROUND AND OBJECTIVE: The influenza vaccination rate among US healthcare workers (HCWs) remains low. This survey was designed to assess influenza vaccination status and related knowledge, attitudes, and beliefs among a national sample of primary care physicians and subspecialists likely to see patients at high risk for complications from influenza. METHODS: We used a mail survey of a national random sample of 495 family physicians (FPs), 491 internists (IMs), 498 geriatricians (GERs), and 497 pulmonologists (PUDs). RESULTS: The overall response rate was 38%. Almost all respondents (87%) reported receiving an influenza vaccine during the 2003-2004 influenza season, with no significant difference across specialty groups (84% FPs, 87% IMs, 87% GERs, 91% PUDs). In a multivariate model, adjusted for physician specialty and age group, significant predictors of vaccination were: strong agreement that HCWs have professional responsibility to be vaccinated, access to vaccination on site and free of charge, strong worksite recommendation for HCWs to be vaccinated, and strong agreement that benefits of vaccination outweigh risk of side effects. CONCLUSIONS: Physicians reported a high influenza vaccination rate. To improve these rates further, with likely benefits for other HCWs, worksite policies that facilitate access to vaccination and documentation of reductions in nosocomial influenza associated with HCW vaccination should continue to be pursued.

Aged↗

PubMed2006

Healthcare workers who elected not to receive smallpox vaccination.

BACKGROUND: The goal of the National Smallpox Vaccination Program was to vaccinate a cadre of healthcare workers and first responders who could care for smallpox patients in the event of an attack. METHODS: Using a convenience sample of health departments (n=49) and hospitals (n=60) in five states, we conducted a telephone interview between July 2003 and April 2004 of healthcare workers and first responders who chose not to receive smallpox vaccination. (Data were analyzed in 2004 and 2005.) RESULTS: The response rate was 63%. Of 1895 respondents, 723 (38.2%) reported having a contraindication, 280 (14.8%) reported being contraindicated because of a household member's condition, and 892 (47.0%) reported having no contraindication to smallpox vaccination. Among respondents with no contraindication, the leading reasons for nonvaccination were concerns about side effects (20.6%) and not feeling that the risk of outbreak was high enough (19.5%). More than half (54.8%) were somewhat or very concerned about having an adverse reaction to the vaccine; Hispanics, blacks, and Asians were significantly more likely than whites to be somewhat or very concerned about side effects. Less than one fifth (17.9%) reported that there was a policy to financially compensate employees who developed side effects from vaccination, and 40.7% reported that there was a policy to provide liability coverage to employees who transmitted vaccinia to a patient. CONCLUSIONS: Many people who chose not to receive smallpox vaccine perceived their personal risk-benefit balance as not favoring vaccination. The success of future smallpox vaccination efforts or vaccination against other bioterrorist health threats depends on addressing potential barriers to participation including compensation and liability issues, in addition to clearly communicating risks and benefits.

Adolescent↗

PubMed2006

Racial similarities in response to standardized offer of influenza vaccination. A MetroNet study.

BACKGROUND: Despite known benefits of influenza vaccination and coverage by Medicare Part B, elderly minority patients are less likely to receive influenza vaccination than whites. OBJECTIVES: To test whether a nonphysician-initiated standardized offer of influenza vaccination to all elderly primary care patients would result in similar proportions of African-American and white patients accepting vaccine. DESIGN: In 7 metropolitan Detroit primary care practices during the 2003 influenza vaccination season, medical assistants assessed influenza immunization status of all patients 65 years and older and collected limited demographic data. Eligible patients were offered vaccination. MEASUREMENTS: Proportion of patients accepting influenza vaccination by race and predictors of vaccine acceptance. RESULTS: Four hundred and fifty-four eligible patients with complete racial information were enrolled: 40% African American, 52% white, 8% other race/ethnicity. Similar proportions of African Americans and whites had already received the 2003 vaccine (11.6% and 11.0%, respectively) or stated vaccination as the reason for visit (23.8% and 30.5%, respectively). Among the remainder, there also were similar proportions who accepted vaccination: 68.9% white and 62.1% African-American patients. History of previous vaccination was the only statistically significant predictor of vaccine acceptance (odds ratio [OR] 8.64, 95% confidence interval [CI] 4.17, 17.91, P<.001). After adjusting for history of previous vaccination, age, gender, and education, the odds of vaccine acceptance were no different for whites and African Americans (OR 1.20, 95% CI 0.63, 2.29, P=.57). CONCLUSIONS: Vaccination acceptance differed little between African-American and white elderly patients. Using nonphysician personnel to identify and offer influenza vaccine to eligible patients is easily accomplished in primary care offices and has the potential to eliminate racial disparities in influenza vaccination.

Black or African American↗

PubMed2006

Factors associated with vaccination of medicare beneficiaries in five U.S. communities: Results from the racial and ethnic adult disparities in immunization initiative survey, 2003.

OBJECTIVES: To examine vaccination in seniors in the five U.S. communities of the Racial and Ethnic Adult Disparities in Immunization Initiative. DESIGN: Cross-sectional telephone survey in spring 2003 using stratified sampling by ZIP code and race/ethnicity. SETTING: New York, Texas, Wisconsin, Illinois, and Mississippi. PARTICIPANTS: Four thousand five hundred seventy-seven Medicare beneficiaries. MEASUREMENTS: Outcomes were pneumococcal vaccination ever and influenza vaccination in 2002/03 and were determined according to race/ethnicity, awareness of vaccination, and provider recommendation. Survey questions also asked about future plans for vaccination, whether respondents believed they had become sick from prior influenza vaccination, and whether unvaccinated respondents would be vaccinated if a health professional recommended it. RESULTS: Pneumococcal vaccination coverage was 70.3% for whites, 40.8% for blacks, and 53.2% for Hispanics, and the proportion reporting provider recommendation for vaccination differed significantly according to race/ethnicity. In multivariate regression, provider recommendation (risk ratio (RR) = 2.32, 95% confidence intervals (CI) = 2.10-2.57) and awareness of vaccination (RR = 1.60, 95% CI = 1.40-1.82) were associated with greater pneumococcal vaccination. Influenza vaccination coverage was 76.2% for whites, 50.7% for blacks, and 65.7% for Hispanics. A little more than half of respondents reported provider recommendation for influenza vaccination, with no differences according to race/ethnicity. Provider recommendation was associated with influenza vaccination (RR = 1.31, 95% CI = 1.25-1.38). More blacks and Hispanics believed they had become sick from prior influenza vaccination than whites, and this belief was associated with lower vaccination rates. CONCLUSION: This survey details vaccination patterns in an ethnically and geographically diverse sample of seniors and identifies some differences between blacks, Hispanics, and whites that may contribute to disparities in vaccination coverage. Survey findings highlight the importance of provider vaccination recommendations.

Black or African American↗

PubMed2005

Influenza vaccination trends among adults 65 years or older in the United States, 1989-2002.

BACKGROUND: Influenza vaccination of elderly individuals (65 years or older) has been recommended in the United States since 1961, and consistent surveillance of vaccine use has been conducted since 1989. We examined national trends in influenza vaccination coverage in the United States from 1989 to 2002 among noninstitutionalized elderly individuals and identified factors associated with receipt of influenza vaccine. METHODS: We analyzed data from the 1989-2002 National Health Interview Surveys, weighted to reflect the civilian, noninstitutionalized US population to determine self-reported levels of influenza vaccination. We conducted multivariable logistic regression modeling of 2002 data to identify factors independently associated with self-reported influenza vaccination. RESULTS: Among the elderly, influenza vaccination coverage increased from 30.5% in 1989 to 65.6% in 2002, with only a 2.4% increase from 1997 to 2002. In 2002, coverage remained lower for the non-Hispanic black (49.6%) and Hispanic (48.5%) populations compared with non-Hispanic whites (68.6%). Characteristics associated with a lower likelihood of influenza vaccination included fewer than 4 physician contacts in the past year and whether a person (1) was divorced or separated, (2) was non-Hispanic black or Hispanic, (3) had no regular physician, and (4) had less than a high school education. Individuals with chronic medical conditions and those 75 years or older were more likely to be vaccinated. CONCLUSIONS: By 1997, influenza vaccination coverage exceeded the Healthy People 2000 objective of 60% for the elderly overall, but even by 2002, this objective was still not achieved in the elderly black and Hispanic populations. Vaccination coverage seems to be leveling off, and innovative initiatives are needed to reach the Healthy People 2010 target of 90%, especially among racial and ethnic minorities.

Aged↗

PubMed2005

Comparison of racial/ethnic disparities in adult immunization and cancer screening.

BACKGROUND: Racial/ethnic disparities in adult influenza and pneumococcal vaccination are marked and poorly understood. The purpose of this study was to contrast these disparities with disparities in other clinical preventive services--mammography and colorectal cancer screening--that are targeted to older populations. METHODS: Data from the 2000 National Health Interview Survey were analyzed in 2004 to determine to what degree race/ethnicity remains a predictor of the receipt of each service after adjusting for personal and health characteristics, socioeconomic status (SES), and access to and utilization of care variables. RESULTS: Blacks and Hispanics were significantly less likely to report receipt of nearly all preventive services examined. Among whites, 57%, 67%, 67%, and 40% reported pneumococcal vaccination, influenza vaccination, mammography, and colorectal cancer screening, respectively. Among blacks, those proportions were 31%, 48%, 60% and 33%, respectively; among English-speaking Hispanics, 35%, 60%, 60%, and 30%, respectively; and among Spanish-speaking Hispanics, 24%, 49%, 52%, and 19%, respectively. After adjusting for personal and health characteristics, socioeconomic factors, and measures of access to and utilization of care, blacks and English- and Spanish-speaking Hispanics remained significantly less likely than whites to report the receipt of pneumococcal vaccination; blacks remained significantly less likely to report influenza vaccination than whites; and Spanish-speaking Hispanics remained significantly less to report colorectal cancer screening than whites. CONCLUSIONS: Most racial/ethnic disparities seen in breast and colorectal cancer screening are explained by differences in SES. In contrast, racial/ethnic disparities in adult immunization persist, and especially for pneumococcal vaccination, suggesting that different barriers may be involved.

Adolescent↗

PubMed2005

Influenza and pneumococcal vaccination of adults aged > or = 65: racial/ethnic differences.

BACKGROUND: Influenza and pneumococcal polysaccharide vaccination (PPV) rates among persons aged > or = 65 years are significantly below national objectives of 90%, particularly among blacks and Hispanics. This study of the 2002-2003 influenza season examines factors that may be associated with low coverage. METHODS: A national sample of 1839 community-dwelling adults aged > or = 65 years was surveyed by telephone during January-May 2003. Outcomes analyzed in 2004-2005 included self-reported influenza vaccination and PPV; place of vaccination; and among the unvaccinated, main reasons for nonvaccination, awareness of vaccination, and receipt of provider recommendation for vaccination. RESULTS: Influenza vaccine coverage was 67.8%, and PPV coverage was 60%. Coverage among blacks and Hispanics was > or = 15 percentage points below that of whites. Half (52%) of persons who had not received PPV were aware it was recommended for persons their age, and < 10% had received a recent physician recommendation for PPV. Concern about side effects and not thinking that they needed the vaccine were the most frequently cited reasons for not receiving an influenza vaccination. In each racial/ethnic group, prevalence of potential missed opportunities (recent doctor visit, but no vaccine recommendation from provider and no influenza vaccination) was higher than prevalence of potential vaccine refusal (recent doctor visit and vaccine recommendation from provider, but no vaccine): blacks, 26.9% versus 7.9%; Hispanics, 19.9% versus 12.1%; and white non-Hispanics, 16.2% versus 6.1%. CONCLUSIONS: Improved adherence to vaccination guidelines by healthcare providers could substantially raise coverage in all racial/ethnic groups. Multiple factors contribute to racial/ethnic disparities, and their relative contributions should be further quantified.

Aged↗

PubMed2004

National availability of influenza vaccine among medical subspecialty practices.

BACKGROUND: Influenza vaccination rates fall short of national goals, particularly among individuals whose chronic conditions predispose them to complications of influenza. Availability of influenza vaccine in medical subspecialists' practices may affect vaccination rates among adults with chronic illness. METHODS: The practice sites of a national random sample of medical cardiology, endocrinology, and pulmonology physicians were contacted by telephone in February 2003 to March 2003 to determine which of them had influenza vaccine available to their patients during the 2002-2003 influenza season. The number of physicians in the practice and geographic location were also obtained. RESULTS: Office staff at the practices of 1683 of 2013 eligible physicians were successfully contacted, and 1473 provided information about vaccine availability. Overall, 1094 (74%) of practices had influenza vaccine available during the 2002-2003 season. Availability differed significantly by subspecialty: 54% cardiology, 78% endocrinology, and 90% pulmonology (p<0.001). Influenza vaccine was more often available at subspecialists' practices in the Northeast (80%) than in the South (74%), Midwest (71%), and West (70%; p<0.005). In multivariate analyses, pulmonology practices in all census regions and sizes were significantly more likely to have influenza vaccine available than was the reference cardiology practice. Several endocrinology practice types also had significantly higher influenza vaccine availability than those in cardiology practice, particularly in multi-physician practices. CONCLUSIONS: Influenza vaccine availability varies widely across practices in the three medical subspecialties that provide care to the largest numbers of individuals with an indication for the vaccine in the United States. These findings have implications for the accessibility of influenza vaccine to individuals at high risk for morbidity and mortality associated with influenza.

Chi-Square Distribution↗

PubMed2003

Nondaily smokers: a descriptive analysis.

To describe the characteristics of persons in the United States who smoke but do not smoke daily, we analyzed 1997-1998 data from the National Health Interview Survey (NHIS). The NHIS collects self-reported information on cigarette smoking from a representative sample of the U.S. civilian, noninstitutionalized population aged 18 years or older through in-home surveys. Nondaily smokers were defined as persons who had ever smoked 100 cigarettes, smoked "some days," and smoked on fewer than 30 of the past 30 days. In 1997-1998, an estimated 16.0% of current smokers were nondaily smokers. Being a nondaily smoker was more common among smokers aged 18-24 years (19.9%) than among those aged 45-64 years (12.0%), more common among Black and Hispanic smokers (19.2% and 29.9%, respectively) than among White smokers (13.9%), and more common among smokers with at least a college education (28.2%) than among those with 9-11, 12, or 13-15 years of education (10.0%, 12.5%, or 15.9%, respectively). Mean cigarettes smoked per day for those who had smoked on 1-9, 10-19, and 20-29 of the past 30 days equaled 3.9, 5.3, and 7.0, respectively, compared with 19.0 for daily smokers. Nondaily smokers were more likely than daily smokers to have a quit attempt in the past year (55.2% vs. 40.0%). In conclusion, rates of nondaily smoking vary substantially by age, race/ethnicity, and educational attainment. Differences by education suggest that this behavior may be influenced by knowledge and social norms. Nondaily smoking may be a useful intermediate outcome for assessing changes in smoking prevalence. Cessation interventions need to be tailored for nondaily smokers, who may differ from daily smokers in important ways.

Adolescent↗

PubMed2002

HIV testing within at-risk populations in the United States and the reasons for seeking or avoiding HIV testing.

OBJECTIVES: We determined proportions of high-risk persons tested for HIV, the reasons for testing and not testing, and attitudes and perceptions regarding HIV testing, information that is critical for planning prevention programs. METHODS: Cross-sectional interview study of persons at high risk for HIV infection (men who have sex with men [MSM]; injection drug users [IDUs]; and heterosexual persons recruited from gay bars, street outreach, and sexually transmitted disease clinics) among six states participating in the HIV Testing Survey (HITS) in 1995 to 1996 (HITS-I) and 1998 to 1999 (HITS-II). RESULTS: Overall testing rates were lower in the HITS-I (1226/1599 [77%]) than in the HITS-II (1375/1711 [80%]) (p =.01). Persons <25 years old tested less frequently than those >or=25 years old (HITS-I: 71% vs. 78%, respectively, p=.007; HITS-II: 63% vs. 85%, respectively, p<.001). The main reasons for testing and not testing were the same in both surveys, but the proportions of reasons for not testing differed (e.g., "unlikely exposed to HIV" [HITS-I (17%) vs. HITS-II (30%), p<.0001], "afraid of finding out HIV-positive" [HITS-I (27%) vs. HITS-II (18%), p<.0001]). Attitudes regarding HIV testing differed among tested and untested respondents, especially among MSM. CONCLUSIONS: HIV testing rates were higher in the HITS-II, but testing rates decreased among the youngest respondents. Denial of HIV risk factors and fear of being HIV-positive were the principal reasons for not being tested. Availability of new HIV therapies may have contributed to decreased fear of finding out that one is HIV infected as a reason to avoid testing. The increased proportion of persons at risk who did not test because they believed they were unlikely to have been exposed highlights the need for prevention efforts to address risk perceptions.

AIDS Serodiagnosis↗

PubMed2002

Exposure to secondhand smoke in the workplace: serum cotinine by occupation.

To examine workplace exposure to secondhand smoke by occupation, we analyzed data from The Third National Health and Nutrition Examination Survey (NHANES III) (1988 to 1994), a nationally representative sample of the noninstitutionalized population. The analysis was restricted to 4952 employed nonsmoking adults who reported no home exposure to cigarette smoke. Occupations were assigned to 40 groups and 7 categories. Among the categories, geometric mean serum cotinine (ng/mL) ranged from 0.09 for farming/forestry/fishing occupations to 0.22 for operators/fabricators/laborers (median, 0.16). The lowest values were observed among farmers and nursery workers (0.06) and the highest among waiters (0.47). Between 1988 to 1991 and 1991 to 1994, the overall geometric mean cotinine and the proportion reporting that they could smell smoke at work decreased significantly. In conclusion, workplace exposure to secondhand smoke varied by occupation, and decreases in exposure occurred between 1988 to 1991 and 1991 to 1994.

Adolescent↗

PubMedDate not supplied

FluSurge--a tool to estimate demand for hospital services during the next pandemic influenza.

PURPOSE: To assess the impact of pandemic influenza on hospital services. METHODS: Based on census data and estimates of hospital resources (non-ICU [intensive care unit] beds, ICU beds, and mechanical ventilators) in a given area, FluSurge software estimates the number of hospital admissions and deaths due to pandemic influenza under variable duration and virulence scenarios and compares hospital resources needed during a pandemic with existing hospital resources. RESULTS: Sample results from Metropolitan Atlanta illustrate how the next influenza pandemic may overwhelm existing hospital resources, given that hospitals increasingly operate at nearly full capacity. CONCLUSIONS: Hospitals need to consider and plan for a surge in demand for hospital services during the next influenza pandemic.

Adolescent↗

PubMedDate not supplied

Lessons learned from inpatient vaccination in Michigan.

This study was a retrospective, preintervention and postintervention evaluation of influenza and pneumococcal vaccination among hospitalized patients eligible for vaccination. The authors abstracted 1476 randomly sampled patient charts to compare vaccination before (2002) or after (2003) implementation of vaccination policies in 4 Michigan hospitals. In addition, they assessed completeness of vaccine assessment forms, evaluated reasons for nonvaccination, and conducted interviews with hospital staff. Vaccination increased at 3 of 4 hospitals after implementation of vaccination policies, yet rates remained low (<10% overall; range, 3.4%-12.4%). Vaccine assessment forms were found in most of the charts in 2003, but almost a third were incomplete. Challenges to implementing inpatient vaccination included support and training of hospital staff, interpretation of vaccination recommendations, lack of systematic prompts for vaccinations, and cost reimbursement. These findings underscore the need for continuous quality improvement and process monitoring to determine strategies for overcoming challenges to inpatient vaccination.

Aged↗

PubMedDate not supplied

Do patterns of knowledge and attitudes exist among unvaccinated seniors?

OBJECTIVE: To examine patterns of knowledge and attitudes among adults aged > 65 years unvaccinated for influenza. METHODS: Surveyed Medicare beneficiaries in 5 areas; clustered unvaccinated seniors by their immunization related knowledge and attitudes. RESULTS: Identified 4 clusters: Potentials (45%) would receive influenza vaccine to prevent disease; Fearful Uninformeds (9%) were unsure if influenza vaccine causes illness; Doubters (27%) were unsure if vaccine is efficacious; Misinformeds (19%) believed influenza vaccine causes illness. More Potentials (75%) and Misinformeds (70%) ever received influenza vaccine than did Fearful Uninformeds (18%) and Doubters (29%). CONCLUSION: Findings suggest that cluster analyses may be useful in identifying groups for targeted health messages.

Aged↗

PubMedDate not supplied

Factors associated with receiving hepatitis B vaccination among high-risk adults in the United States: an analysis of the National Health Interview Survey, 2000.

BACKGROUND AND OBJECTIVES: Although an effective vaccine against hepatitis B has been licensed in the United States since 1981, and successful childhood vaccination programs have been implemented, hepatitis B virus transmission continues to occur among high-risk adults. In this study, we identified factors associated with receipt of one or more doses of hepatitis B vaccine among adults at high risk for hepatitis B infection. METHODS: We analyzed data from the 2000 National Health Interview Survey of selected adults ages 18-49 years who were at high risk for hepatitis B infection (n=1,036). Multivariable regression analysis was conducted to determine factors independently associated with vaccination. RESULTS: Although more than 80% (n=841) of high-risk adults reported previous visits to a clinician during the past year, only 30% (n=498) of men and 31% (n=538) of women reported having received a single dose of hepatitis B vaccine. Young age (18-29 years), never being married, past blood donation, and past human immunodeficiency virus (HIV) testing were independently associated with receiving vaccination for men. For women, young age (18-29 years) and previous vaccinations were significant factors associated with vaccination receipt. Additionally, having a primary care source (men) and seeing an obstetrician-gynecologist provider in the past year (women) were significantly associated with vaccination. CONCLUSIONS: Hepatitis B vaccination rates for high-risk adults are low, and missed opportunities are frequent. Additional strategies are needed to increase immunization rates of adults at high risk for hepatitis B.

Adolescent↗