title: Impact on health departments after a seventh grade hepatitis B immunization requirement.
abstract: OBJECTIVE
  This research was designed to evaluate the impact on health departments of the implementation of a 1999 policy requiring hepatitis B (HBV) vaccination for seventh grade school entry in the state of Missouri.
  
  
  METHODS
  The authors employed a retrospective descriptive design using data from the Missouri Health Strategic Architectures and Information Cooperative (MOHSAIC) system. They based their assessment of the impact of the new policy on six outcome variables: total immunizations administered, HBV immunizations administered, HBV immunizations given to children ages 10 to 14, percentage of total immunizations that were HBV, percentage of total HBV immunizations that were given to children ages 10 to 14, and percentage of total immunizations that were HBV given to children ages 10 to 14. Outcome variables from the months of July through September 1998 were compared to similar data from the same period in 1999.
  
  
  RESULTS
  Statewide, there was a significant increase in all outcome variables. Health departments in non-rural settings, however, did not have a significant increase in total immunizations (t = -1.49, p = 0.158). The number of HBV immunizations did increase at health departments where alternative strategies (e.g., school-based programs) were used, but the increase was not as dramatic as for sites where no such strategies were employed.
  
  
  CONCLUSIONS
  Implementation of a state policy requiring additional immunizations can be expected to have a significant impact on the resources of health departments statewide. The use of alternative strategies for managing immunizations outside the traditional health department setting can limit that impact.
authors.affiliation: University of Missouri-Kansas City, School of Nursing, Kansas City, MO 64108, USA. wilsontr@umkc.edu
authors.forename: Thad
authors.initials: T
authors.lastname: Wilson
authors.forename: Rhonda
authors.initials: R
authors.lastname: Luther
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D006509:Hepatitis B / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000600:supply & distribution*; D006801:Humans; D017589:Immunization Programs / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D008923:Missouri; D016134:Organizational Policy; D011635:Public Health Administration; D040442:Public Health Informatics; D012189:Retrospective Studies; D012423:Rural Health; D012570:School Admission Criteria
chemical_list: D017325:Hepatitis B Vaccines