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Hepatitis A vaccination coverage among adults 18-49 years traveling to a country of high or intermediate endemicity, United States.
Vaccine. 2013 May 01; 31(19):2348-57.V

Abstract

BACKGROUND

Since 1996, hepatitis A vaccine (HepA) has been recommended for adults at increased risk for infection including travelers to high or intermediate hepatitis A endemic countries. In 2009, travel outside the United States and Canada was the most common exposure nationally reported for persons with hepatitis A virus (HAV) infection.

OBJECTIVE

To assess HepA vaccination coverage among adults 18-49 years traveling to a country of high or intermediate endemicity in the United States.

METHODS

We analyzed data from the 2010 National Health Interview Survey (NHIS), to determine self-reported HepA vaccination coverage (≥1 dose) and series completion (≥2 dose) among persons 18-49 years who traveled, since 1995, to a country of high or intermediate HAV endemicity. Multivariable logistic regression and predictive marginal analyses were conducted to identify factors independently associated with HepA vaccine receipt.

RESULTS

In 2010, approximately 36.6% of adults 18-49 years reported traveling to high or intermediate hepatitis A endemic countries; among this group unadjusted HepA vaccination coverage was 26.6% compared to 12.7% among non-travelers (P-values<0.001) and series completion were 16.9% and 7.6%, respectively (P-values<0.001). On multivariable analysis among all respondents, travel status was an independent predictor of HepA coverage and series completion (both P-values<0.001). Among travelers, HepA coverage and series completion (≥2 doses) were higher for travelers 18-25 years (prevalence ratios 2.3, 2.8, respectively, P-values<0.001) and for travelers 26-39 years (prevalence ratios 1.5, 1.5, respectively, P-value<0.001, P-value=0.002, respectively) compared to travelers 40-49 years. Other characteristics independently associated with a higher likelihood of HepA receipt among travelers included Asian race/ethnicity, male sex, never having been married, having a high school or higher education, living in the western United States, having greater number of physician contacts or receipt of influenza vaccination in the previous year. HepB vaccination was excluded from the model because of the significant correlation between receipt of HepA vaccination and HepB vaccination could distort the model.

CONCLUSIONS

Although travel to a country of high or intermediate hepatitis A endemicity was associated with higher likelihood of HepA vaccination in 2010 among adults 18-49 years, self-reported HepA vaccination coverage was low among adult travelers to these areas. Healthcare providers should ask their patients' upcoming travel plans and recommend and offer travel related vaccinations to their patients.

Authors+Show Affiliations

Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, NE, Atlanta, GA 30333, United States. lhp8@cdc.govNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23523408

Citation

Lu, Peng-Jun, et al. "Hepatitis a Vaccination Coverage Among Adults 18-49 Years Traveling to a Country of High or Intermediate Endemicity, United States." Vaccine, vol. 31, no. 19, 2013, pp. 2348-57.
Lu PJ, Byrd KK, Murphy TV. Hepatitis A vaccination coverage among adults 18-49 years traveling to a country of high or intermediate endemicity, United States. Vaccine. 2013;31(19):2348-57.
Lu, P. J., Byrd, K. K., & Murphy, T. V. (2013). Hepatitis A vaccination coverage among adults 18-49 years traveling to a country of high or intermediate endemicity, United States. Vaccine, 31(19), 2348-57. https://doi.org/10.1016/j.vaccine.2013.03.011
Lu PJ, Byrd KK, Murphy TV. Hepatitis a Vaccination Coverage Among Adults 18-49 Years Traveling to a Country of High or Intermediate Endemicity, United States. Vaccine. 2013 May 1;31(19):2348-57. PubMed PMID: 23523408.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hepatitis A vaccination coverage among adults 18-49 years traveling to a country of high or intermediate endemicity, United States. AU - Lu,Peng-Jun, AU - Byrd,Kathy K, AU - Murphy,Trudy V, Y1 - 2013/03/21/ PY - 2012/05/06/received PY - 2013/02/26/revised PY - 2013/03/11/accepted PY - 2013/3/26/entrez PY - 2013/3/26/pubmed PY - 2014/2/11/medline SP - 2348 EP - 57 JF - Vaccine JO - Vaccine VL - 31 IS - 19 N2 - BACKGROUND: Since 1996, hepatitis A vaccine (HepA) has been recommended for adults at increased risk for infection including travelers to high or intermediate hepatitis A endemic countries. In 2009, travel outside the United States and Canada was the most common exposure nationally reported for persons with hepatitis A virus (HAV) infection. OBJECTIVE: To assess HepA vaccination coverage among adults 18-49 years traveling to a country of high or intermediate endemicity in the United States. METHODS: We analyzed data from the 2010 National Health Interview Survey (NHIS), to determine self-reported HepA vaccination coverage (≥1 dose) and series completion (≥2 dose) among persons 18-49 years who traveled, since 1995, to a country of high or intermediate HAV endemicity. Multivariable logistic regression and predictive marginal analyses were conducted to identify factors independently associated with HepA vaccine receipt. RESULTS: In 2010, approximately 36.6% of adults 18-49 years reported traveling to high or intermediate hepatitis A endemic countries; among this group unadjusted HepA vaccination coverage was 26.6% compared to 12.7% among non-travelers (P-values<0.001) and series completion were 16.9% and 7.6%, respectively (P-values<0.001). On multivariable analysis among all respondents, travel status was an independent predictor of HepA coverage and series completion (both P-values<0.001). Among travelers, HepA coverage and series completion (≥2 doses) were higher for travelers 18-25 years (prevalence ratios 2.3, 2.8, respectively, P-values<0.001) and for travelers 26-39 years (prevalence ratios 1.5, 1.5, respectively, P-value<0.001, P-value=0.002, respectively) compared to travelers 40-49 years. Other characteristics independently associated with a higher likelihood of HepA receipt among travelers included Asian race/ethnicity, male sex, never having been married, having a high school or higher education, living in the western United States, having greater number of physician contacts or receipt of influenza vaccination in the previous year. HepB vaccination was excluded from the model because of the significant correlation between receipt of HepA vaccination and HepB vaccination could distort the model. CONCLUSIONS: Although travel to a country of high or intermediate hepatitis A endemicity was associated with higher likelihood of HepA vaccination in 2010 among adults 18-49 years, self-reported HepA vaccination coverage was low among adult travelers to these areas. Healthcare providers should ask their patients' upcoming travel plans and recommend and offer travel related vaccinations to their patients. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/23523408/Hepatitis_A_vaccination_coverage_among_adults_18_49_years_traveling_to_a_country_of_high_or_intermediate_endemicity_United_States_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(13)00295-8 DB - PRIME DP - Unbound Medicine ER -