First hepatitis B vaccine uptake in neonates prior to and during the COVID-19 pandemic.

Abstract

Routine vaccination for hepatitis B is recommended at birth, and most infants should be vaccinated within 24h of life. Historically, vaccination rates have been less than ideal, and routine vaccination has been further complicated by the COVID-19 pandemic, with decreased uptake of many vaccines. This retrospective study assessed hepatitis B vaccination rates at birth before and after the start of the COVID-19 pandemic and explored the factors associated with lower vaccination rates. Infants born at a single academic medical center in Charleston, South Carolina from November 1, 2018 through June 30, 2021 were identified. Infants were excluded if they died or received≥7days of systemic steroid therapy within the first 37days of life. Maternal and infant baseline characteristics and uptake of the first hepatitis B vaccine during hospital admission were recorded. A total of 7808 infants were included in the final analysis, with an overall vaccine uptake of 91.6%. Of the 3880 neonates in the pre-pandemic group, 3583 (92.3%) were vaccinated, versus 3571 (90.9%) of 3928 neonates in the pandemic group (rate difference=1.4%; 95% confidence interval -2.8% to 5.7%, p=0.52). Factors independently associated with lower vaccine uptake included being of non-Hispanic white race, born to a married mother, birth weight<2kg, and parental refusal of erythromycin eye ointment at birth. The COVID-19 pandemic did not significantly affect the uptake of inpatient neonatal hepatitis B vaccination. Several patient-specific factors were associated with suboptimal vaccination rates in this population.