Compliance with hepatitis B virus vaccination in a high-risk population.

Authors: Froehlich H,West DJ,
Address: Department of Pediatrics, Fresno Community, St. Agnes, California, USA. froehlich.h@ghc.org
Journal: Ethn Dis.

Publication: 2001 Autumn;11(3):548-53.

abstract

OBJECTIVE:

To quantify cultural barriers to hepatitis B virus (HBV) vaccination and parental Compliance with a specific vaccination protocol among a primarily among population of infants born at a community hospital.

METHODS:

This study was concurrent with an immunogenicity study of two vaccination schedules and occurred prior to the inception of universal infant vaccination with hepatitis B vaccine (HepB). In this study, parental pairs were interviewed, consent obtained, subjects were randomly assigned to each group, and first immunization was administered in the hospital. Follow-up contacts required for completion were documented.

RESULTS:

Of 260 eligible parental pairs interviewed, 175 (67%) declined participation, mainly because of fears of vaccine side effects (55%) or ignorance of the hepatitis B virus (HBV) (30%). Of 85 infants enrolled in the study, 28 (33%) were later withdrawn from the study; 13 (46%) of these 28 infants were withdrawn at the request of parents. Each infant who completed the study received 5 postcards, 10 phone calls, and 3 home visits.

CONCLUSIONS:

Families were unaware of the risk of HBV infection and feared vaccination. Aversion to subjecting an infant to pain was a principal reason for failure to complete the study, and frequent contacts were required to ensure adherence. Existence of a safe and effective hepatitis B vaccine and universal vaccination is unlikely to change deeply felt attitudes against vaccination. Current vaccination strategies must take these prejudices into account.

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