Initiation and Completion of the Hepatitis A Vaccine Series among a Privately Insured US Pediatric Population
Methods: We conducted a retrospective, observational study using the MarketScan® Commercial Claims Database. The study population was comprised of children born between years 2005 and 2009 that were continuously enrolled for at least 31/2 years from the date of birth. Multivariate analyses were performed to understand factors associated with HepA vaccine series initiation and completion.
Results: There were 202,513 eligible children included in this study. HepA series initiation increased from 60% in the 2005 birth cohort to 81% for the 2009 birth cohort (Fig 1). Series completion among those who had a 1st HepA dose increased from 75% to 85% for the 2005 and 2009 cohorts, respectively. Among the 26% of children not receiving their 1st dose of HepA vaccination, 63% had ≥ 1 visit where they received another vaccination but not HepA, 89% had ≥ 1 well-child visit and 98% had ≥ 1 doctor office visit. Among the 13% of children who did not complete the HepA vaccine series after at least 6 months from the 1st dose, 36% had ≥ 1 visit where they received another vaccination but not HepA, 48% had ≥ 1 well-child visit and 75% had ≥ 1 doctor office visits (Fig 2).
Children were more likely to initiate and complete the HepA vaccine series if they were from more recent birth cohorts, from states with a HepA vaccination recommendation prior to the ACIP universal recommendation, from states with daycare/school entry requirements, were enrolled in an HMO health plan, or had pediatricians as primary providers.
Conclusion: In this study, approximately one in every four children remained unvaccinated against HepA. Although the HepA vaccine series initiation and completion improved from 2005 to 2009, vaccine coverage has stabilized in recent years. It is important for providers to identify every opportunity for HepA vaccination, to assure that children get protection from this vaccine-preventable disease.
Merck: Employee, Salary
N. N. Borse, Merck: Consultant, Consulting fee
E. Walter, Merck: Collaborator, Consultant and Investigator, Consulting fee