In 1991, the Advisory Committee on Immunisation Practices recommended that all newborns receive the first dose of the vaccine before leaving the hospital or at age one to two months. In 2002, however, this recommendation was changed to indicate a preference for vaccination prior to hospital discharge. Finally, in 2005, the guidelines were again revised to recommend pre-hospital discharge hepatitis B vaccination for all medically stable infants weighing at least 2 000 grams.
The present findings are based on an analysis of survey data obtained after the 2002 guidelines were implemented but before the 2005 ones were in place.
Overall, 43 percent of newborns received the first dose of the hepatitis B vaccine by age one day and 50 percent had received it by age three days, CDC researchers report in Morbidity and Mortality Weekly Report, publication of the CDC.
Wide variations in vaccine coverage were seen between cities and states. Detroit, Michigan had the highest coverage at 77,5 percent, while Fresno County, California had the lowest at about eight percent.
Infants infected with the hepatitis B virus have a 90 percent chance of becoming chronically infected, which can lead to cirrhosis and liver cancer, CDC researchers note.
Delivery hospitals play a key role in the national strategy to prevent hepatitis B transmission and should have policies and procedures in place to ensure that hepatitis B vaccination is administered to all newborns before they leave the hospital, they emphasise.