title: Hepatitis a vaccination coverage among adolescents in the United States.
abstract: OBJECTIVE
  Hepatitis A infection causes severe disease among adolescents and adults. The Advisory Committee on Immunization Practices instituted incremental recommendations for hepatitis A vaccination (HepA) at 2 years of age based on risk (1996), in selected states (1999), and universally at 1 year of age, with vaccination through 18 years of age based on risk or desire for protection (2006). We assessed adolescent HepA coverage in the United States and factors independently associated with vaccination.
  
  
  METHODS
  Data from the 2009 National Immunization Survey-Teen (n = 20 066) were analyzed to determine ≥1- and ≥2-dose HepA coverage among adolescents 13 to 17 years of age. We used bivariate and multivariable analyses to test associations between HepA initiation and sociodemographic characteristics stratified by state groups: group 1, universal child vaccination since 1999; group 2, consideration for child vaccination since 1999; group 3, universal child vaccination at 1 year of age since 2006.
  
  
  RESULTS
  In 2009, national 1-dose HepA coverage among adolescents was 42.0%. Seventy percent of vaccinees completed the 2-dose series. One-dose coverage was 74.3% among group 1 states, 54.0% for group 2 states, and 27.8% for group 3 states. The adjusted prevalence ratios of vaccination initiation were highest for states with a vaccination requirement and for adolescents whose providers recommended HepA.
  
  
  CONCLUSIONS
  HepA coverage was low among most adolescents in the United States in 2009 leaving a large population susceptible to hepatitis A infection maturing into adulthood.
authors.affiliation: National Center for Immunization and Respiratory Diseases, Atlanta, GA 30333, USA. cdorell@cdc.gov
authors.forename: Christina G
authors.initials: CG
authors.lastname: Dorell
authors.forename: David
authors.initials: D
authors.lastname: Yankey
authors.forename: Kathy K
authors.initials: KK
authors.lastname: Byrd
authors.forename: Trudy V
authors.initials: TV
authors.lastname: Murphy
mesh_terms: D000293:Adolescent; D002675:Child, Preschool; D005260:Female; D006306:Health Surveys; D006506:Hepatitis A / Q000517:prevention & control*; D022362:Hepatitis A Vaccines / Q000008:administration & dosage*; D006801:Humans; D007115:Immunization Schedule; D007117:Immunization, Secondary / Q000706:statistics & numerical data; D007223:Infant; D008297:Male; D032541:Mass Vaccination / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data; D011204:Poverty Areas; D012959:Socioeconomic Factors; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data
chemical_list: D022362:Hepatitis A Vaccines