Impact of Recommendations to Suspend the Birth Dose of Hepatitis B Virus Vaccine

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Abstract
The Advisory Committee for Immunization Practices (ACIP) and the American Academy of Pediatrics (AAP) recommended universal vaccination of infants with hepatitis B virus (HBV) vaccine in November 1991 (Table 1),1,2 and subsequently the 3-dose series became well integrated into the schedule of childhood vaccines.3,4 A unique feature of the HBV vaccination series, administration of the first dose at birth, has been desirable for 2 reasons: it substantially decreases the risk of vertical transmission in mothers who are positive for hepatitis B surface antigen (HBsAg), or whose HBsAg status is unknown,5 and it has also been associated with on-time receipt of the HBV series and other childhood vaccines.3,4 Infants living in public housing in Chicago who received the first dose of HBV vaccine soon after birth were more likely to complete the HBV vaccine series by 19 months of age, to receive the first DTP vaccine dose on time, and to complete the 4:3:1 series by age 19 months.3 The National Immunization Survey, a nationwide random-digit dialing telephone survey, confirmed that children who received the first dose of HBV vaccine at birth were more likely to have completed the series vs those who received the first HBV vaccine dose later.4