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Hepatitis B in the United States: ongoing missed opportunities for hepatitis B vaccination, evidence from the Behavioral Risk Factor Surveillance Survey, 2007

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An Erratum to this article was published on 17 February 2012

Abstract

Purpose

In the USA, the burden of hepatitis B disproportionately affects high-risk adults who alone account for more than 75% of newly reported hepatitis B virus infections each year. Despite the localization of new infections in identifiable high-risk groups, vaccination rates in this subgroup, with the exception of health care workers, remain consistently low. The purpose of this study was to characterize those at risk for hepatitis B transmission and quantify the association between missed opportunities and hepatitis B vaccination.

Methods

Data from the 2007 Behavioral Risk Factor Surveillance Survey (BRFSS) of adults aged 18 years and older who were at high risk for hepatitis B infection (n = 15,432) were analyzed. Multivariate regression analysis was conducted to determine factors independently associated with vaccination.

Results

In a nationally representative sample, 51.4% of high-risk adults remained unvaccinated against hepatitis B and more than 50% had a missed opportunity for vaccination. High-risk adults who were vaccinated against pneumonia and influenza had a higher odds ratio of being vaccinated against hepatitis B than those not vaccinated against pneumonia and influenza (OR 2.27 and 1.67, respectively). Also, high-risk adults tested for human immunodeficiency virus (HIV) at a counseling and testing site or a drug treatment facility had a higher OR of being vaccinated than those who had not been tested for HIV (OR 1.78 and 1.73, respectively). The opposite relationship was true among individuals tested for HIV at a correctional facility (OR 0.60).

Conclusions

The findings of this study underscore the inadequacy of vaccination coverage in high-risk adults and highlight advantageous opportunities to bridge gaps in vaccination coverage.

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Authors and Affiliations

  1. Program in Public Health, Division of Biomedicine, Brown University, 121 South Main Street, Box G, Providence, RI, 02903, USA

    F. Ladak

  2. Program in Public Health, Center for Population Health and Clinical Epidemiology, Brown University, 121 South Main St. S121-2, Providence, RI, 02912, USA

    A. Gjelsvik

  3. Warren Alpert Medical School, Brown University, Box G-S121, 121 South Main Street, Providence, RI, 02912, USA

    E. Feller

  4. Division of Biomedicine, Brown University, 121 South Main Street, Box G, Providence, RI, 02903, USA

    S. Rosenthal

  5. Infectious Diseases, Brown University/Miriam Hospital, 164 Summit Ave, Providence, RI, 02906, USA

    B. T. Montague

  6. 72 Orchard Avenue, Barrington, RI, 02806, USA

    F. Ladak

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  1. F. Ladak
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  2. A. Gjelsvik
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  5. B. T. Montague
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Correspondence to F. Ladak.

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Ladak, F., Gjelsvik, A., Feller, E. et al. Hepatitis B in the United States: ongoing missed opportunities for hepatitis B vaccination, evidence from the Behavioral Risk Factor Surveillance Survey, 2007. Infection 40, 405–413 (2012). https://doi.org/10.1007/s15010-011-0241-2

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  • DOI: https://doi.org/10.1007/s15010-011-0241-2

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