title: Hepatitis B vaccination coverage among high-risk adults 18-49 years, U.S., 2009.
abstract: BACKGROUND
  Approximately 43,000 new hepatitis B virus (HBV) infections occurred in 2007. Although hepB vaccination has been recommended for adults at high-risk for incident HBV infection for many years, coverage remains low.
  
  
  METHODS
  We used the 2009 National Health Interview Survey to assess self-reported HepB vaccine uptake (≥ 1 dose), series completion (≥ 3 dose), and independent predictors of vaccination among high-risk adults aged 18-49 years. High-risk adults were defined as those reporting male sex with men; injection drug use; hemophilia with receipt of clotting factors; sexually transmitted disease in prior five years; sex for money or drugs; HIV positive; sex with persons having any above risk factors; or who "felt they were at high risk for HIV". Persons with none of the aforementioned risk factors were considered non-high risk. Bivariate analysis was conducted to assess vaccination coverage. Independent predictors of vaccine uptake and series completion were determined using a logistic regression.
  
  
  RESULTS
  Overall, 7.0% adults aged 18-49 years had high-risk behaviors. Unadjusted coverage with ≥ 1 dose was 50.5% among high-risk compared to 40.5% among non-high-risk adults (p-values <0.001) while series completion (≥ 3 doses) was 41.8% and 34.2%, respectively (p-values <0.001). On multivariable analysis, ≥ 1 dose coverage, but not series completion, was higher (Risk Ratio 1.1, 95% CI=1.0-1.2, p-value=0.021) among high-risk compared to non-high risk adults. Other characteristics independently associated with a higher likelihood of HepB vaccination among persons 18-49 years included younger age groups, females, higher education, ≥ 2 physician contacts in the past year, ever tested for HIV, health care personnel, received influenza vaccination in the previous year, and ever received hepatitis A vaccination. Vaccine uptake with ≥ 1 dose increased by 5.1% (p=0.047) among high-risk adults between 2004 and 2009.
  
  
  CONCLUSIONS
  A small increase in ≥ 1 dose HepB vaccination coverage among high-risk adults compared with non-high risk adults was documented for the first time in 2009. Higher coverage among persons 18-30 years may reflect aging of persons vaccinated when they were children and adolescents. To improve protection against hepatitis B among high-risk adults, healthcare providers should offer hepatitis B vaccination to persons at high risk and those who seek vaccination to protect themselves and facilitate timely completion of the three (3) dose HepB series.
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mail Stop E-62, Atlanta, GA 30333, USA. plu@cdc.gov
authors.forename: Peng-jun
authors.initials: PJ
authors.lastname: Lu
authors.forename: Kathy K
authors.initials: KK
authors.lastname: Byrd
authors.forename: Trudy V
authors.initials: TV
authors.lastname: Murphy
authors.forename: Cindy
authors.initials: C
authors.lastname: Weinbaum
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006509:Hepatitis B / Q000453:epidemiology / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D057566:Self Report; D012919:Social Behavior; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D017325:Hepatitis B Vaccines