Infants who do not receive the hepatitis B birth dose vaccine are less likely to receive all recommended vaccines at 18 and 24 months, according to results published in the Journal of Infection.
These results indicated that parents form opinions about vaccinations even before their child is born, which suggests that clinicians should make efforts to influence parental attitudes about vaccines before birth.
The retrospective study included infants born during 1 year at an academic medical center. Infants were classified into 2 groups: not vaccinated at birth, which consisted of those who did not receive the hepatitis B birth dose vaccine within 7 days of life, and vaccinated at birth, which included those who did. The primary outcome was vaccination status at 18 months of age. The researchers used the state vaccination registry to determine outcomes.
At 18 months, 44% of infants in the vaccinated at birth group had received all recommended vaccines compared to 23% of those in the not vaccinated at birth group (P <.001). At 24 months, 65% of infants in the vaccinated at birth group had received all recommended vaccines compared to 45% of those in the not vaccinated at birth group (P <.001).
The researchers found that more than 80% of the variability in vaccination completions were linked to 1 latent variable, which they hypothesized to be vaccine hesitancy/refusal.
“Future efforts for increased uptake of the birth dose of [the hepatitis B vaccine] should target pre-pregnancy and prenatal visits as crucial decision-making periods regarding vaccination,” the researchers wrote.
Wilson P, Taylor G, Knowles J, et al. Missed hepatitis B birth dose vaccine is a risk factor for incomplete vaccination at 18 and 24 months [published online October 4, 2018]. J Infect. doi: 10.1016/j.jinf.2018.09.014