National Progress Report 2020 Goal: Increase the percentage of infants who receive hepatitis B vaccine within 3 days of birth to 85.0%

Percentage of children aged 19–35 months* who received hepatitis B vaccine within 3 days of birth

Bar chart for years 2010-2020, charting percentage, starting at 64.1 in 2010, peaking at 64.2 by 2013, then declining to 71.1 in 2016 and then projected at 85 by 2020.

Source: CDC, National Immunization Survey-Child (12)
*For 2010, children born 1/2007–5/2009; for 2011, children born 1/2008–5/2010; for 2012, children born 1/2009–5/2011; for 2013, children born 1/2010–5/2012; for 2014, children born 1/2011–5/2013; for 2015, children born 1/2012–5/2014; and for 2016, children born 1/2013–5/2015.
†One dose of hepatitis B vaccination administered from birth through age 3 days.

Summary of Findings

The percentage of infants receiving hepatitis B vaccine within 3 days of birth increased from 64.1% in 2010 to 74.2% in 2013 but decreased to 71.1% in 2016, below the 2016 annual target of 76.6% coverage.

Increase needed to meet 2020 goal: A 19.5% increase from the vaccination percentage reported in 2016 is needed to meet the 2020 goal of 85%.

This increase can best be achieved by

  • Ensuring that providers continue to follow existing immunization schedules and Advisory Committee on Immunization Practices (ACIP) Vaccine Recommendations and Guidelines.
  • Assisting birthing facilities in implementing routine vaccination of all newborns within 24 hours of birth for medically stable infants weighing ≥2,000 grams (3).
  • Assessing hospital measures and reimbursement policies to identify and remove any barriers to infants receiving the birth dose.

Technical Notes

Data Source: CDC, National Immunization Survey-Child (NIS-Child)

Numerator: Number of children aged 19–35 months who received hepatitis B vaccine within 3 days of birth

Denominator: Number of children aged 19–35 months

Indicator Notes: (12, 4) The NIS-Child monitors vaccination coverage among children aged 19–35 months in the 50 states, the District of Columbia, selected local areas, and U.S. territories using a random-digit dialing sample of landline and cellular telephone numbers. After identifying a household with at least one age-eligible child, a telephone interview is conducted to collect sociodemographic characteristics for all age-eligible children and to request permission to contact the child’s vaccination providers. If consent is given, a survey is mailed to each provider to request the child’s vaccination history, including dates of receipt of vaccine doses. Data are weighted to represent the population of children aged 19–35 months, with adjustments for households with multiple telephone lines and mixed telephone use (landline and cellular), household nonresponse, and exclusion of households without telephone service. Beginning in 2011, surveys include landline and cellular telephone households.  NIS-Child data for 2010 include children born January 2007 through May 2009; for 2011, children born January 2008 through May 2010; for 2012, children born January 2009 through May 2011; for 2013, children born January 2010 through May 2012; for 2014, children born January 2011 through May 2013; for 2015, children born January 2012 through May 2014; and for 2016, children born January 2013 through May 2015.

Goal Setting: The 2020 goal of 85% is consistent with the Healthy People 2020 ObjectiveExternal (IID-7.8) and with other national programs, regulations, policies, and laws and was selected based on modeling of NIS data from 2003–2008. These data showed an average increase of 2.46% per year, making 85% coverage an achievable 2020 goal. The 85% Healthy People 2020 goal was also subsequently adopted in both CDC’s Viral Hepatitis Strategic Plan, 2016-2020Cdc-pdf[PDF – 17 pages] and HHS’s National Viral Hepatitis Action Plan, 2017-2020Cdc-pdf[PDF – 84 pages]External. Annual targets assume a constant (linear) rate of change from the observed baseline (2014) to the 2020 goal.

Limitations: Low response rates, incomplete sampling frames, and potential misclassification of vaccination status in the NIS may lead to bias in estimating vaccination coverage. Additionally, although the birth dose is now recommended to be administered within 24 hours of birth, no survey measure is currently available to assess this new recommendation (3).

References

  1. Hill HA, Elam-Evans LD, Yankey D, Singleton JA, Kang Y. Vaccination coverage among children aged 19-35 months – United States, 2016. MMWR Morbidity and Mortality Weekly Report. 2017; 66(43):1171-1177.
  2. Hill HA, Elam-Evans LD, Yankey D, Singleton JA, Kolasa M. National, state, and local area vaccination coverage among children aged 19-35 months – United States, 2014. MMWR Morbidity and Mortality Weekly Report. 2015; 64(33):889-896.
  3. Schillie S, Vellozzi C, Reingold A, harris A, Haber P, Ward JW, Nelson NP. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recommendations and Reports. 2018 Jan 12;67(1):1-31.
  4. Centers for Disease Control and Prevention. Datasets and Related Documentation for the National Immunization Survey. http://www.cdc.gov/nchs/nis/data_files.htm. Accessed April 5, 2017.