Uptake and Behavioural and Attitudinal Determinants of Immunization in an Expanded Routine Infant Hepatitis B Vaccination Program in British Columbia

Abstract

British Columbia (BC) implemented a universal infant hepatitis B (HB) immunization program in 2001. The study objective was to evaluate HB immunization coverage among the first six-month cohort of eligible infants in the province outside of the Vancouver-Richmond health region and to assess parent/guardian behavioural and attitudinal determinants of HB immunization. A cross-sectional survey of HB immunization was conducted using a random sample of eligible infants born between 1 January-30 June 2001. HB immunization coverage data were obtained from the provincial Public Health Information System, and through a telephone survey of 487 of eligible infants' parents/guardians that was conducted between October 2002-January 2003. At this time, parents/guardians were also asked about behaviours and attitudes towards immunization, based on the Immunization Health Belief Model Scale. HB immunization coverage with at least one dose of HB vaccine was 89% and uptake of 3 doses of HB vaccine was 78%. HB immunization was significantly associated (p<0.001) with a recommendation for HB immunization from a health care professional. The main reason for non-HB immunization was parental concern about side effects. Seventy-eight percent of infants completed the 3-dose HB vaccination schedule. Parental behaviour regarding HB immunization of their children was strongly influenced by a supportive recommendation from either a nurse or doctor.