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Regional differences in infant immunization against hepatitis B: did intervention work?

J I Takayama·J P Iser·A Gandelman
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Abstract

OBJECTIVE: The impact of a community intervention to establish hospital nursery policies for universal newborn immunization against hepatitis B was determined by comparing primary care physician immunization practices in two counties, one intervention and one control. METHODS: Surveys were mailed to 855 physicians in 1994; 322 of 533 respondents were eligible, with 155 from San Francisco (SF), the intervention county, and 167 from Sacramento (SAC), the control county. Adoption of universal hepatitis B immunization was defined as immunizing more than 90% of infants seen in 1993. RESULTS: Although similar proportions of physicians agreed, 79% in SF and 72% in SAC, 64% of SF physicians and 40% of SAC physicians adopted universal infant immunization (P < 0.0001). Universal immunization was greater for pediatricians than for family physicians (OR = 2.00, 95% CI 1.66-2.41) but less for physicians who perceived their patients population to be at low risk for hepatitis B compared to those who did not (OR = 0.60, 95% CI 0.45-0.79). While 94% of physicians in both counties indicated their willingness to provide the second and third doses of the hepatitis B vaccine if the first dose had been administered in the newborn nursery, 64% of SF in contrast to 30% of SAC physicians reported routine nursery administration of the vaccine (P < 0.0001). CONCLUSIONS: Primary care physician adoption of universal hepatitis B infant immunization and routine nursery administration of the first dose of the vaccine were both greater in San Francisco than in Sacramento, suggesting impact of a community intervention to increase hepatitis B immunization rates.

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AdultAttitude of Health PersonnelAttitude to HealthCaliforniaCross-Sectional StudiesFamily PracticeFemaleGuideline AdherenceHealth Care SurveysHepatitis BHepatitis B VaccinesHumansImmunization ProgramsImmunization ScheduleInfant, NewbornMaleMiddle AgedNurseries, HospitalProgram EvaluationRisk AssessmentSan FranciscoStatistics as TopicVaccinationJournal Article

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BibTeXRIS

J I Takayama, J P Iser, A Gandelman. 1999. Regional differences in infant immunization against hepatitis B: did intervention work?. https://doi.org/10.1006/pmed.1998.0390

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