Online Program

Medical providers' attitudes and practices regarding the hepatitis b vaccine universal birth dose in New Jersey delivery hospitals, 2011–2012

Wednesday, November 6, 2013

Andria Apostolou, PhD, MPH, Communicable Disease Service, New Jersey Department of Health, Trenton, NJ
Miranda Chan, MPH, Communicable Disease Service, New Jersey Department of Health, Trenton, NJ
Barbara Montana, MD, MPH, FACP, Communicable Disease Service, New Jersey Department of Health, Trenton, NJ
BACKGROUND: The CDC recommends universal Hepatitis B birth dose to prevent HBV transmission to infants. The 2011 National Immunization Survey, ranked New Jersey (NJ) 49th among all states for Hepatitis B birth dose vaccination rates (NJ: 47.3%; nationwide: 68.6%).

METHODS: Pediatricians, obstetricians/gynecologists, and nurses from NJ hospitals were identified through outreach to professional societies and hospitals. Using an electronic survey we assessed their knowledge of hospital policies and procedures, and barriers to birth dose administration.

RESULTS: The survey was completed by 228 providers. Nine percent of participants correctly estimated NJ birth dose rates; 69% were aware of written hospital policies. Three percent indicated that vaccination consent is obtained before delivery. Only 14% of pediatricians and 34% of obstetricians/gynecologists reported always discussing birth dose with parents before admission. Pediatricians indicated parental refusal (70%), ease of monitoring immunizations in private practice (70%), and belief that it was not necessary for most of their patients (60%) as reasons for not administering the vaccine. Among pediatricians, 23.5% reported that obstetricians/gynecologists never communicated the maternal HBV status after admission, and reported limited communication before admission; 39% of obstetricians/gynecologists reported never discussing the birth dose after admission with the pediatricians.

CONCLUSIONS: Our results demonstrate a lack of knowledge regarding NJ birth dose rates and hospital policies. Further outreach to providers and necessary. NJ delivery hospitals might consider obtaining consent before delivery to achieve better vaccination rates. Increasing communication between parents, pediatricians and obstetricians/gynecologists before and after admission can help improve birth dose rates.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Other professions or practice related to public health
Protection of the public in relation to communicable diseases including prevention or control

Learning Objectives:
Evaluate programs pertaining to Maternal Child Health, especially in regards to immunizations Analyze survey data and provide recommendations Compare attitudes and practices among pediatricians, obstetrician/gynecologists and nurses in regards to the Hepatitis B universal birth dose

Keyword(s): Immunizations, Hepatitis B

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a CDC assignee to the NJ Department of Health as the Epidemic Intelligence Service Officer and currently as a Health Systems Integration Scholar. I have worked extensively on surveillance, outbreak investigations and program and policy evaluations for communicable diseases (especially in vaccine preventable diseases) and other public health issues. Among my scientific interests has been immunizations and program evaluations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.