A hepatitis B vaccination programme for inner metropolitan Sydney neonates

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Abstract
OBJECTIVE; To review the effectiveness of a hepatitis B vaccination programme for high risk infants within a mobile urban population. A follow-up study of 1429 infants enrolled consecutively in the programme from September 1987 to December 1988. The programme was established in early childhood centres within inner metropolitan Sydney, an area where 30% of residents were born in non-English speaking countries and where doubts had previously been expressed about the efficacy of vaccination. Neonates born to mothers who were surface antigen positive, born in selected countries with a 5% prevalence of surface antigen carriage, Aboriginal or intravenous drug users. Documented vaccination given by early childhood centre nurses. Some adjustment was made for parents' reports of vaccination given elsewhere. Two vaccinations were given to 87% and three to 73% of these infants. If we include vaccinations apparently given elsewhere we estimate that 92% may have been fully protected. The programme produced high rates of compliance with vaccinations within a population where the delivery of such a service was thought to be difficult. Experience with the current State policy for hepatitis B vaccination indicates that it may not optimally reduce the pool of surface antigen carriers within our community.