Increasing Hepatitis B Vaccine Prevalence Among Refugee Children Arriving in the United States, 2006-2012.
To determine whether the addition of hepatitis B virus (HBV) vaccine to national immunization programs improved vaccination rates among refugee children, a marginalized population with limited access to care.



The sample included 2291 refugees younger than 19 years who completed HBV screening after arrival in the United States. Children were categorized by having been born before or after the addition of the 3-dose HBV vaccine to their birth country's national immunization program. The outcome was serological evidence of immunization.



The odds of serological evidence of HBV immunization were higher for children born after the addition of HBV vaccine to their birth country's national immunization program (adjusted odds ratio = 2.54; 95% confidence interval = 2.04, 3.15).



National HBV vaccination programs have contributed to the increase in HBV vaccination coverage observed among US-bound refugee children.



Ongoing public health surveillance is needed to ensure that vaccine rates are sustained among diverse, conflict-affected, displaced populations.
At the time the work was conducted, Katherine Yun was with PolicyLab, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Kailey Urban and Blain Mamo were with the Refugee Health Program, Minnesota Department of Health, Saint Paul. Jasmine Matheson was with the Refugee Health Program, Washington State Department of Health, Shoreline. Colleen Payton and Kevin C. Scott were with Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA. Lihai Song was with the Healthcare Analytics Unit, Center for Pediatric Clinical Effectiveness, and PolicyLab, The Children's Hospital of Philadelphia. William M. Stauffer was with the Departments of Medicine and Pediatrics, University of Minnesota, Minneapolis. Barbara L. Stone was with the Refugee Health Program, Colorado Department of Public Health and Environment, Denver. Janine Young was with General Pediatrics, Denver Health and Hospitals, Denver, CO. Henry Lin was with the Division of Gastroenterology, The Children's Hospital of Philadelphia.
Katherine
K
Yun
At the time the work was conducted, Katherine Yun was with PolicyLab, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Kailey Urban and Blain Mamo were with the Refugee Health Program, Minnesota Department of Health, Saint Paul. Jasmine Matheson was with the Refugee Health Program, Washington State Department of Health, Shoreline. Colleen Payton and Kevin C. Scott were with Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA. Lihai Song was with the Healthcare Analytics Unit, Center for Pediatric Clinical Effectiveness, and PolicyLab, The Children's Hospital of Philadelphia. William M. Stauffer was with the Departments of Medicine and Pediatrics, University of Minnesota, Minneapolis. Barbara L. Stone was with the Refugee Health Program, Colorado Department of Public Health and Environment, Denver. Janine Young was with General Pediatrics, Denver Health and Hospitals, Denver, CO. Henry Lin was with the Division of Gastroenterology, The Children's Hospital of Philadelphia.
Kailey
K
Urban
At the time the work was conducted, Katherine Yun was with PolicyLab, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Kailey Urban and Blain Mamo were with the Refugee Health Program, Minnesota Department of Health, Saint Paul. Jasmine Matheson was with the Refugee Health Program, Washington State Department of Health, Shoreline. Colleen Payton and Kevin C. Scott were with Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA. Lihai Song was with the Healthcare Analytics Unit, Center for Pediatric Clinical Effectiveness, and PolicyLab, The Children's Hospital of Philadelphia. William M. Stauffer was with the Departments of Medicine and Pediatrics, University of Minnesota, Minneapolis. Barbara L. Stone was with the Refugee Health Program, Colorado Department of Public Health and Environment, Denver. Janine Young was with General Pediatrics, Denver Health and Hospitals, Denver, CO. Henry Lin was with the Division of Gastroenterology, The Children's Hospital of Philadelphia.
Blain
B
Mamo
At the time the work was conducted, Katherine Yun was with PolicyLab, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Kailey Urban and Blain Mamo were with the Refugee Health Program, Minnesota Department of Health, Saint Paul. Jasmine Matheson was with the Refugee Health Program, Washington State Department of Health, Shoreline. Colleen Payton and Kevin C. Scott were with Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA. Lihai Song was with the Healthcare Analytics Unit, Center for Pediatric Clinical Effectiveness, and PolicyLab, The Children's Hospital of Philadelphia. William M. Stauffer was with the Departments of Medicine and Pediatrics, University of Minnesota, Minneapolis. Barbara L. Stone was with the Refugee Health Program, Colorado Department of Public Health and Environment, Denver. Janine Young was with General Pediatrics, Denver Health and Hospitals, Denver, CO. Henry Lin was with the Division of Gastroenterology, The Children's Hospital of Philadelphia.
Jasmine
J
Matheson
At the time the work was conducted, Katherine Yun was with PolicyLab, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Kailey Urban and Blain Mamo were with the Refugee Health Program, Minnesota Department of Health, Saint Paul. Jasmine Matheson was with the Refugee Health Program, Washington State Department of Health, Shoreline. Colleen Payton and Kevin C. Scott were with Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA. Lihai Song was with the Healthcare Analytics Unit, Center for Pediatric Clinical Effectiveness, and PolicyLab, The Children's Hospital of Philadelphia. William M. Stauffer was with the Departments of Medicine and Pediatrics, University of Minnesota, Minneapolis. Barbara L. Stone was with the Refugee Health Program, Colorado Department of Public Health and Environment, Denver. Janine Young was with General Pediatrics, Denver Health and Hospitals, Denver, CO. Henry Lin was with the Division of Gastroenterology, The Children's Hospital of Philadelphia.
Colleen
C
Payton
At the time the work was conducted, Katherine Yun was with PolicyLab, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Kailey Urban and Blain Mamo were with the Refugee Health Program, Minnesota Department of Health, Saint Paul. Jasmine Matheson was with the Refugee Health Program, Washington State Department of Health, Shoreline. Colleen Payton and Kevin C. Scott were with Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA. Lihai Song was with the Healthcare Analytics Unit, Center for Pediatric Clinical Effectiveness, and PolicyLab, The Children's Hospital of Philadelphia. William M. Stauffer was with the Departments of Medicine and Pediatrics, University of Minnesota, Minneapolis. Barbara L. Stone was with the Refugee Health Program, Colorado Department of Public Health and Environment, Denver. Janine Young was with General Pediatrics, Denver Health and Hospitals, Denver, CO. Henry Lin was with the Division of Gastroenterology, The Children's Hospital of Philadelphia.
Kevin C
KC
Scott
At the time the work was conducted, Katherine Yun was with PolicyLab, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Kailey Urban and Blain Mamo were with the Refugee Health Program, Minnesota Department of Health, Saint Paul. Jasmine Matheson was with the Refugee Health Program, Washington State Department of Health, Shoreline. Colleen Payton and Kevin C. Scott were with Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA. Lihai Song was with the Healthcare Analytics Unit, Center for Pediatric Clinical Effectiveness, and PolicyLab, The Children's Hospital of Philadelphia. William M. Stauffer was with the Departments of Medicine and Pediatrics, University of Minnesota, Minneapolis. Barbara L. Stone was with the Refugee Health Program, Colorado Department of Public Health and Environment, Denver. Janine Young was with General Pediatrics, Denver Health and Hospitals, Denver, CO. Henry Lin was with the Division of Gastroenterology, The Children's Hospital of Philadelphia.
Lihai
L
Song
At the time the work was conducted, Katherine Yun was with PolicyLab, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Kailey Urban and Blain Mamo were with the Refugee Health Program, Minnesota Department of Health, Saint Paul. Jasmine Matheson was with the Refugee Health Program, Washington State Department of Health, Shoreline. Colleen Payton and Kevin C. Scott were with Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA. Lihai Song was with the Healthcare Analytics Unit, Center for Pediatric Clinical Effectiveness, and PolicyLab, The Children's Hospital of Philadelphia. William M. Stauffer was with the Departments of Medicine and Pediatrics, University of Minnesota, Minneapolis. Barbara L. Stone was with the Refugee Health Program, Colorado Department of Public Health and Environment, Denver. Janine Young was with General Pediatrics, Denver Health and Hospitals, Denver, CO. Henry Lin was with the Division of Gastroenterology, The Children's Hospital of Philadelphia.
William M
WM
Stauffer
At the time the work was conducted, Katherine Yun was with PolicyLab, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Kailey Urban and Blain Mamo were with the Refugee Health Program, Minnesota Department of Health, Saint Paul. Jasmine Matheson was with the Refugee Health Program, Washington State Department of Health, Shoreline. Colleen Payton and Kevin C. Scott were with Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA. Lihai Song was with the Healthcare Analytics Unit, Center for Pediatric Clinical Effectiveness, and PolicyLab, The Children's Hospital of Philadelphia. William M. Stauffer was with the Departments of Medicine and Pediatrics, University of Minnesota, Minneapolis. Barbara L. Stone was with the Refugee Health Program, Colorado Department of Public Health and Environment, Denver. Janine Young was with General Pediatrics, Denver Health and Hospitals, Denver, CO. Henry Lin was with the Division of Gastroenterology, The Children's Hospital of Philadelphia.
Barbara L
BL
Stone
At the time the work was conducted, Katherine Yun was with PolicyLab, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Kailey Urban and Blain Mamo were with the Refugee Health Program, Minnesota Department of Health, Saint Paul. Jasmine Matheson was with the Refugee Health Program, Washington State Department of Health, Shoreline. Colleen Payton and Kevin C. Scott were with Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA. Lihai Song was with the Healthcare Analytics Unit, Center for Pediatric Clinical Effectiveness, and PolicyLab, The Children's Hospital of Philadelphia. William M. Stauffer was with the Departments of Medicine and Pediatrics, University of Minnesota, Minneapolis. Barbara L. Stone was with the Refugee Health Program, Colorado Department of Public Health and Environment, Denver. Janine Young was with General Pediatrics, Denver Health and Hospitals, Denver, CO. Henry Lin was with the Division of Gastroenterology, The Children's Hospital of Philadelphia.
Janine
J
Young
At the time the work was conducted, Katherine Yun was with PolicyLab, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Kailey Urban and Blain Mamo were with the Refugee Health Program, Minnesota Department of Health, Saint Paul. Jasmine Matheson was with the Refugee Health Program, Washington State Department of Health, Shoreline. Colleen Payton and Kevin C. Scott were with Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA. Lihai Song was with the Healthcare Analytics Unit, Center for Pediatric Clinical Effectiveness, and PolicyLab, The Children's Hospital of Philadelphia. William M. Stauffer was with the Departments of Medicine and Pediatrics, University of Minnesota, Minneapolis. Barbara L. Stone was with the Refugee Health Program, Colorado Department of Public Health and Environment, Denver. Janine Young was with General Pediatrics, Denver Health and Hospitals, Denver, CO. Henry Lin was with the Division of Gastroenterology, The Children's Hospital of Philadelphia.
Henry
H
Lin
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D014943:Global Health / Q000706:statistics & numerical data*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007223:Infant; D008297:Male; D015995:Prevalence; D062486:Public Health Surveillance; D012036:Refugees / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult
D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines