title: Effect of Combination Vaccines on Hepatitis B Vaccine Compliance in Children in the United States.
abstract: An increasingly crowded immunization schedule threatens the completion and compliance of hepatitis B vaccinations (HepB), the primary method of hepatitis B prevention. Combination vaccines have been proposed to alleviate this problem.
  
  
  
  Data from the 2011 National Immunization Survey Public-Use Data File were utilized (GSK study identifier: HO-11-770) to compare HepB completion and compliance rates between 3 groups of children: those who received HepB combination vaccine, those who received non-HepB combination vaccine and those who received HepB single-antigen vaccine only. Completion was defined as the accumulation of 3 HepB doses by 18 months. Compliance was defined as the receipt of vaccine doses within the Advisory Committee on Immunization Practices' recommended age ranges.
  
  
  
  Of a sample of 4,040,116 children, 39.4% received a HepB combination vaccine, 43.0% received a non-HepB combination vaccine and 17.5% received a HepB single-antigen vaccine. Overall, 91.2% of children completed all 3 recommended doses, but only 61.8% completed them at age-appropriate times. Those receiving single-antigen only (odds ratio = 0.25, 95% confidence interval: 0.17-0.35) or non-HepB combination vaccines (odds ratio = 0.50, 95% confidence interval: 0.37-0.69) were substantially less likely to complete 3 doses of HepB than those who received the HepB combination vaccine.
  
  
  
  Although completion rates were high, a large proportion of children did not receive HepB doses at age-appropriate times. Combination vaccine was associated with both higher completion and compliance outcomes compared with HepB single-antigen vaccine.
authors.affiliation: From the *RTI Health Solutions, Research Triangle Park, NC; and †Janssen, Pharmaceutical Companies of Johnson and Johnson, Raritan, NJ.
authors.forename: Samantha K
authors.initials: SK
authors.lastname: Kurosky
authors.forename: Keith L
authors.initials: KL
authors.lastname: Davis
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Galindo
mesh_terms: D000328:Adult; D002675:Child, Preschool; D005260:Female; D017325:Hepatitis B Vaccines; D006801:Humans; D008297:Male; D009035:Mothers; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011203:Poverty; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data*; D017778:Vaccines, Combined; D055815:Young Adult
chemical_list: D017325:Hepatitis B Vaccines; D017778:Vaccines, Combined