Implementation of government recommendations for immunising infants at risk of hepatitis B

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Abstract
We produced a neonatal pack for hepatitis B vaccination for attachment to the notes of pregnant women who were infected with hepatitis B virus and were attending the antenatal clinic in North Manchester General Hospital. The pack comprised instruction sheets for the obstetric and paediatric staff and a vaccination notification form. When the virology department identified hepatitis B infection in a pregnant woman the consultant virologist sent her consultant obstetrician the pack with a letter explaining the results and detailing the recommended prophylactic schedule. After the birth the on call paediatrician was notified and administered recombinant vaccine (10 µg, Smith-Kline Beecham), with or without specific immunoglobulin, and then completed and sent two notification forms. One form initiated arrangements for vaccination at 1 and 6 months in the community paediatric clinic, and the other initiated arrangements for collecting blood samples from high risk babies in hospital at 6 and 12 months. The community and hospital clinics sent two appointments for each vaccination and venepuncture, and a health visitor called if the parents failed to attend with their baby. A retrospective one year audit of this vaccination programme was performed using hospital, community, and virology records.