An assessment of the performance of self-reported vaccination status for hepatitis B, National Health and Nutrition Examination Survey 1999-2008.
OBJECTIVE
We sought to assess the performance of self-reported vaccination with hepatitis B vaccine (HepB) compared with serological status for hepatitis B markers in the general US civilian population.


METHODS
Using 1999 through 2008 National Health and Nutrition Examination Survey data, we calculated 3 measures of agreement between self-reported HepB vaccination status and serological status: percent concordance, and positive (PPV) and negative predictive values (NPV) of self-report. Logistic regression was used to identify factors associated with agreement between self-report and serological status.


RESULTS
Overall agreement was 83% (95% CI = 82.3, 83.7), NPV of self-report was high (0.95; 95% CI = 0.93, 0.95) and PPV was low (0.53; 95% CI = 0.51, 0.54). Birth year relative to the 1991 recommendation for universal infant HepB vaccination had a strong association with agreement, however, the association was positive for those who reported receiving at least 3 doses and negative for those who reported receiving no doses.


CONCLUSIONS
Although the low PPV in our study could be attributable in part to waning of vaccine-induced anti-HBs over time, national adult HepB vaccination coverage may be lower than previously estimated because national estimates usually depend on self-report of vaccine receipt.
Maxine M. Denniston, R. Monina Klevens, and Ruth B. Jiles are with the Epidemiology and Surveillance Branch, Kathy K. Byrd is with the Prevention Branch, and Jan Drobeniuc and Saleem Kamili are with the Laboratory Branch, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Maxine M
MM
Denniston
Kathy K
KK
Byrd
R Monina
RM
Klevens
Jan
J
Drobeniuc
Saleem
S
Kamili
Ruth B
RB
Jiles
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D019983:Guideline Adherence; D006306:Health Surveys; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines / Q000276:immunology / Q000627:therapeutic use*; D006801:Humans; D007115:Immunization Schedule; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D057566:Self Report; D055815:Young Adult
D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines