Parental Knowledge, Attitudes, and Practices Associated With Not Receiving Hepatitis A Vaccine in a Demonstration Project in Butte County, California

Author:

Bardenheier Barbara1,González Idalia M.1,Washington Michael L.2,Bell Beth P.3,Averhoff Francisco1,Massoudi Mehran S.1,Hyams Insu4,Simard Edgar P.3,Yusuf Hussain1

Affiliation:

1. Immunization Services Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia

2. Data Management Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia

3. Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

4. Butte County Department of Public Health, Oroville, California

Abstract

Objective. To determine hepatitis A vaccination coverage and factors associated with not receiving hepatitis A vaccine among children. Methods. A random cluster sample survey was conducted of parents of children who attended kindergarten in Butte County, California, in 2000. Because of a history of recurrent epidemics, an aggressive hepatitis A vaccination program was ongoing during the time this study was conducted. Receipt of 1 or 2 doses of hepatitis A vaccine was studied. Results. Of 896 surveys sent, 648 (72%) were completed. The vaccination coverage for at least 1 dose of hepatitis A vaccine was 398 (62%) and for 2 doses was 272 (42%). Factors associated with not receiving the vaccine included lack of provider recommendation (vs having recommendation; odds ratio [OR]: 7.8; 95% confidence interval [CI]: 4.9–12.2), not having heard of the vaccine (OR: 2.4; 95% CI: 1.2–4.9), and parent’s not perceiving child is likely to get hepatitis A (vs perceiving child might get disease; OR: 2.1; CI: 1.6–2.9). Conclusions. Vaccination coverage among kindergartners did not reach high levels (ie, >90%), despite aggressive vaccination efforts in this community. Lack of provider recommendation and lack of parental awareness of hepatitis A vaccine were the 2 most significant factors associated with failure to receive vaccine. These findings will facilitate the development of vaccination strategies for communities in which hepatitis A vaccination is recommended.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Reference24 articles.

1. Armstrong GL, Bell BP. Hepatitis A virus infections in the United States: model-based estimates and implications for childhood immunization. Pediatrics.2002;109:839–845

2. Centers for Disease Control and Prevention. Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep.1999;48(RR-12):1–37

3. Centers for Disease Control and Prevention. Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep.1996;45(RR-15):1–30

4. Averhoff F, Shapiro C, Bell B, et al. Control of hepatitis A through routine vaccination of children. JAMA.2001;283:2968–2973

5. Woodruff BA, Unti L, Coyle K, et al. Parents’ attitudes toward school-based hepatitis B vaccination of their children. Pediatrics.1996;98:410–413

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