Effect of state vaccine-financing strategy on hepatitis B immunization in hospital nurseries

Michael D. Cabana, Kimberly D. Aiken, Matthew M. Davis, Gary L. Freed, Sarah J. Clark

Research output: Contribution to journalArticle

5 Scopus citations


Objective. - Changes in recommendations for newborn hepatitis B vaccination offer an opportunity to examine the association between newborn hepatitis B vaccination in hospital nurseries and state vaccine-financing strategies, which include the Vaccines for Children (VFC) program alone, an enhanced VFC program, and universal purchase. Methods. - We conducted a cross-sectional telephone survey of nursery directors from a national random sample of 290 hospital nurseries. Results. - Directors at 207 (71%) of 290 eligible nurseries responded. After the end of the temporary suspension of the hepatitis B vaccine birth dose, 59 (29%) of the 207 nurseries did not return to their previous policy and adopted a less strict policy for offering this vaccination to low-risk infants. In logistic regression analysis, compared with nurseries in states with VFC-only financing, nurseries in states with universal purchase financing were more likely to return a strict policy of routinely offering hepatitis B vaccination (odds ratio [OR], 0.09; 95% confidence interval [CI], 0.11-0.78), and nurseries in states with enhanced VFC financing were less likely to return to a strict policy of routinely offering hepatitis B vaccination (OR, 3.00; 95% CI, 1.14-7.88). The presence of residents or students in the nursery was associated with a lower likelihood of not returning to a strict policy of routinely offering hepatitis B vaccination (OR, 0.32; 95% CI, 0.10-0.97). Conclusions. - State vaccine-financing strategy for the birth dose of hepatitis B vaccine is associated with nursery policy to routinely offer this vaccine in the nursery. The temporary change in national hepatitis B vaccination recommendations in 1999 served as a window of opportunity for the adoption of new hospital nursery policies and showed the effects of state vaccine financing on the adoption of newborn immunization recommendations.

Original languageEnglish (US)
Pages (from-to)367-374
Number of pages8
JournalAmbulatory Pediatrics
Issue number5
StatePublished - Jan 1 2002
Externally publishedYes



  • Financing
  • Hepatitis B
  • Newborn care
  • Vaccines

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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