Post Doc Research Fellow Beth Israel Deaconess Medical Center Boston, Massachusetts, United States
Background: Newborns and young infants are the intended recipients of several vaccines due to their developmentally distinct immune system and increased vulnerability to infection. Yet, they are often inadequately vaccinated due to parental/caregiver concerns regarding vaccine tolerance, safety, or effectiveness. The American Academy of Pediatrics (AAP) recommends the first dose of hepatitis B vaccine within 24 hours for medically stable infants over 2000 grams and within 30 days or discharge for those born under 2000 grams. However, these guidelines are often not followed, particularly in neonatal intensive care units (NICU), leading to incomplete or delayed hepatitis B vaccination in susceptible newborns. Objective: Assess longitudinal trends in the rates and timing of the first dose of Hepatitis B vaccination at our birth hospital (Beth Israel Deaconess Medical Center) between 2013 and 2023. We hypothesize that adherence to the AAP recommendations on neonatal hepatitis B vaccination has worsened since the start of the COVID-19 pandemic, and that infants admitted to the NICU are exposed to reduced hepatitis B vaccination rates at the time of hospital discharge and delayed vaccine administration compared to AAP recommendations. Design/Methods: This is a retrospective data analysis on hepatitis B vaccination rates for infants born in a large delivery center in Boston, MA from 2013 to 2023. Analysis will focus on evaluating the rates of hepatitis B vaccination prior hospital discharge (gold standard =100%) and the time of the first hepatitis B vaccination post-birth in infants (gold standard per AAP guidelines based on birth weight). Different analyses will be performed for the well-baby nursery and the NICU. We will use a Chi-square test to compare vaccination rates between infants weighing >2000g and < 2000g, and a multivariate regression analysis to evaluate possible associations with socio-demographic factors. Timeline: November-December of 2023: IRB application approval and data collection. January-February of 2024: data analysis. All results will be complete by April 1, 2024.
