The Effect of Vaccinated Children on Increased Hepatitis B Immunization Among High-Risk Adults

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http://www.ajph.org/cgi/content/abstract/98/5/832

May 2008, Vol 98, No. 5 | American Journal of Public Health 832-838

© 2008 American Public Health Association

DOI: 10.2105/AJPH.2007.116046

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RESEARCH AND PRACTICE

The Effect of Vaccinated Children on Increased Hepatitis B Immunization Among

High-Risk Adults

Deepika L. Koya, MD, MSCR, G. Hill, PhD and M. Darden, MD

Deepika L. Koya is with the Health Services Research/Academic Generalist

Fellowship Program and the Department of Internal Medicine, Medical University

of South Carolina, ton. M. Darden is with the Health Services

Research/Academic Generalist Fellowship Program, the Departments of Internal

Medicine; Pediatrics; and Biostatistics, Bioinformatics, and Epidemiology,

Medical University of South Carolina, ton. G. Hill is with the

Department of Biostatistics, Bioinformatics, and Epidemiology, Medical

University of South Carolina, ton.

Correspondence: Requests for reprints should be sent to Deepika L. Koya, MD,

MSCR, 135 Rutledge Ave, Room 280, Medical University of South Carolina,

ton, SC 29425 (e-mail: koyald@...).

Objectives. We sought to examine trends in hepatitis B virus (HBV) vaccination

among high-risk adults and assess the potential effect vaccinated adolescents

have on these trends as they age.

Methods. We used data from the National Health Interview Survey 2000, 2002, and

2004 to examine trends in HBV vaccination among high-risk adults aged 18 to 49

years and in age subgroups (18–29, 30–39, and 40–49 years). We investigated

temporal differences in vaccination rates for the 18- to 29-year-old cohort with

model-based linear contrasts constructed from a logistic regression model with

age and survey year as predictors.

Results. There was a significant increasing trend in vaccination prevalence

across the 3 survey years (32.6%, 35.3%, and 41.4%; trend test, P=.001). We

found that respondents aged 18 to 29 years were more likely to be vaccinated in

2004 than in 2000, after adjusting for relevant confounders (odds ratio=1.73;

95% confidence interval=1.14, 2.6); there was no significant increase in

vaccination for the other cohorts.

Conclusions. A cohort effect, in which successfully vaccinated adolescents have

reached young adulthood, contributes significantly to recent trends showing

improved HBV vaccination among high-risk adults.

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