title: Baseline hepatitis B vaccination coverage among persons with diabetes before implementing a U.S. recommendation for vaccination.
abstract: BACKGROUND
  Recent data suggest that adults with diabetes are at increased risk of incident hepatitis B infection and may suffer increased morbidity or mortality from chronic hepatitis B infection. In October 2011, the Advisory Committee on Immunization Practices (ACIP) recommended hepatitis B vaccination (HepB) for persons with diabetes aged 19-59 years and stated that persons with diabetes aged 60 years and older should be considered for vaccination.
  
  
  OBJECTIVE
  To determine HepB coverage among persons with diabetes aged ≥19 years prior to implementation of the new ACIP recommendation and to determine predictors for vaccination.
  
  
  METHODS
  We used the 2009 National Health Interview Survey to determine weighted proportions of self-reported HepB coverage (≥1 and ≥3 doses) among persons with diabetes aged ≥19 years. A multivariable logistic regression analysis was performed to determine factors independently associated with vaccination.
  
  
  RESULTS
  Overall, 19.5% (95% CI: 17.4-21.6%) and 16.6% (14.7-18.6%) of persons with diabetes, aged ≥19 years, reported receiving ≥1 and ≥3 doses of HepB, respectively, compared with 30.3% (29.4-31.3%) and 26.5% (25.5-27.4%) among persons without diabetes. While unadjusted HepB coverage was higher among persons without diabetes, diabetes status was not associated with ≥1 or ≥3 dose vaccination. Among persons with diabetes, being a healthcare provider (OR 4.2, 2.5-7.0), ever tested for HIV (OR 2.6, 1.8-3.6), high-risk behaviors (OR 1.8, 1.0-3.4, P-value=0.053) and having some college education (OR 1.7, 1.2-2.4) were all independently associated with vaccination.
  
  
  CONCLUSIONS
  HepB coverage among persons with diabetes is low. These data can be used to provide a baseline for measuring future progress toward vaccination of persons with diabetes.
authors.affiliation: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, & TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States. gdn8@cdc.gov
authors.forename: Kathy K
authors.initials: KK
authors.lastname: Byrd
authors.forename: Peng-jun
authors.initials: PJ
authors.lastname: Lu
authors.forename: Trudy V
authors.initials: TV
authors.lastname: Murphy
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000517:prevention & control*; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D017325:Hepatitis B Vaccines