Factors Associated With Hepatitis A Vaccination Among Children 24 to 35 Months of Age: United States, 2003

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Abstract
OBJECTIVES. In 1999, the Advisory Committee on Immunization Practices made recommendations for hepatitis A vaccination of children according to historic rates of hepatitis A incidence in different regions of the country. The objective of this study was to examine hepatitis A vaccination coverage rates among children living in states with different vaccination recommendations and to examine individual characteristics associated with vaccination. METHODS. Hepatitis A vaccination status data were collected for children 24 to 35 months of age through the National Immunization Survey, a telephone survey with health care provider-verified vaccination results. Vaccination status data were collected from children in each of the 50 states and 28 selected urban areas. RESULTS. In 2003, 50.9% (95% confidence interval [CI]: 47.6–54.2%) of children living in 11 states where routine hepatitis A vaccination is recommended had received ≥1 dose, compared with 25.0% (95% CI: 21.8–28.2%) of children in 6 states where vaccination is suggested and 1.4% (95% CI: 1.0–1.8%) of children in 33 states without a recommendation. Coverage was higher among children who lived in urban areas, were Hispanic or American Indian/Alaska Native, or were born to women with less education. CONCLUSIONS. Hepatitis A vaccination is being targeted successfully to children at higher risk of infection; however, overall vaccination coverage remains lower for hepatitis A vaccination, compared with other routine childhood vaccinations.