title: Acceptance of hepatitis B vaccination by pregnant adolescents.
abstract: OBJECTIVE
  To determine (1) the rate of prenatal hepatitis B virus (HBV) vaccine acceptance in HBV nonimmune pregnant adolescents, (2) if postulated behavioral and attitudinal factors are associated with HBV vaccine, and (3) the rate of actual receipt of HBV vaccine postpartum in eligible subjects.
  
  
  METHODS
  During 1999-2000, at an inner-city tertiary-care center prenatal clinic, 160 HBV nonimmune adolescents <18 years who were receiving prenatal and delivery care at the center were identified. The research nurse provided an HBV information pamphlet and offered immediate in-hospital postpartum HBV vaccination. Risk factors for nonacceptance of the vaccine were measured with structured questionnaires and medical record review documenting care attendance. Subsequently, all subjects, irrespective of prenatal acceptance of vaccine, were offered vaccine before postpartum discharge, and the rate of actual acceptance was determined.
  
  
  RESULTS
  In these predominantly African American (95%) adolescents, the rate of vaccine acceptance was 91%. Actual vaccination rate was 86%, but it was not associated with prior acceptance of vaccination or behavioral or attitudinal factors.
  
  
  CONCLUSIONS
  Acceptance of vaccination and actual vaccination were high in this population of high-risk adolescents. The authors found that reoffering vaccine was a successful intervention, even with adolescents who had less-than-optimal attendance at prenatal visits. Given the high rate of acceptance and vaccination in this setting, the authors would encourage public health programs to implement vaccination programs in adolescent prenatal clinics and to offer vaccination postpartum to those who do not receive it prenatally.
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, USA. stringer@nursing.upenn.edu
authors.forename: Marilyn
authors.initials: M
authors.lastname: Stringer
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Ratcliffe
authors.forename: Robert
authors.initials: R
authors.lastname: Gross
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D017325:Hepatitis B Vaccines; D006801:Humans; D007258:Informed Consent; D008137:Longitudinal Studies; D008403:Mass Screening / Q000458:organization & administration; D016389:Maternal-Child Nursing / Q000458:organization & administration; D009511:New England; D015403:Nursing Evaluation Research; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000458:organization & administration*; D011181:Postnatal Care / Q000523:psychology / Q000706:statistics & numerical data; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000523:psychology*; D011295:Prenatal Care / Q000458:organization & administration*; D015397:Program Evaluation; D000297:Psychology, Adolescent; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data
chemical_list: D017325:Hepatitis B Vaccines