title: Compliance with hepatitis B virus vaccination in a high-risk population.
abstract: OBJECTIVE
  To quantify cultural barriers to hepatitis B virus (HBV) vaccination and parental compliance with a specific vaccination protocol among a primarily among population of infants born at a community hospital.
  
  
  METHODS
  This study was concurrent with an immunogenicity study of two vaccination schedules and occurred prior to the inception of universal infant vaccination with hepatitis B vaccine (HepB). In this study, parental pairs were interviewed, consent obtained, subjects were randomly assigned to each group, and first immunization was administered in the hospital. Follow-up contacts required for completion were documented.
  
  
  RESULTS
  Of 260 eligible parental pairs interviewed, 175 (67%) declined participation, mainly because of fears of vaccine side effects (55%) or ignorance of the hepatitis B virus (HBV) (30%). Of 85 infants enrolled in the study, 28 (33%) were later withdrawn from the study; 13 (46%) of these 28 infants were withdrawn at the request of parents. Each infant who completed the study received 5 postcards, 10 phone calls, and 3 home visits.
  
  
  CONCLUSIONS
  Families were unaware of the risk of HBV infection and feared vaccination. Aversion to subjecting an infant to pain was a principal reason for failure to complete the study, and frequent contacts were required to ensure adherence. Existence of a safe and effective hepatitis B vaccine and universal vaccination is unlikely to change deeply felt attitudes against vaccination. Current vaccination strategies must take these prejudices into account.
authors.affiliation: Department of Pediatrics, Fresno Community, St. Agnes, California, USA. froehlich.h@ghc.org
authors.forename: H
authors.initials: H
authors.lastname: Froehlich
authors.forename: D J
authors.initials: DJ
authors.lastname: West
mesh_terms: D003466:Cultural Characteristics; D006509:Hepatitis B / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D010349:Patient Compliance; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014744:Vietnam / Q000208:ethnology
chemical_list: D017325:Hepatitis B Vaccines