Self-reported hepatitis A vaccination as a predictor of hepatitis A virus antibody protection in U.S. adults: National Health and Nutrition Examination Survey 2007–2012

Details

• Alternative Title:
  Vaccine
• Personal Author:
  Denniston, Maxine M. ; Klevens, R. Monina ; Jiles, Ruth B. ; Murphy, Trudy V.
• Description:
  Objectives
  
  To estimate the predictive value of self-reported hepatitis A vaccine (HepA) receipt for the presence of hepatitis A virus (HAV) antibody (anti-HAV) from either past infection or vaccination, as an indicator of HAV protection.
  
  Methods
  
  Using 2007–2012 National Health and Nutrition Examination Survey data, we assigned participants to 4 groups based on self-reported HepA receipt and anti-HAV results. We compared characteristics across groups and calculated three measures of agreement between self-report and serologic status (anti- HAV): percentage concordance, and positive (PPV) and negative (NPV) predictive values. Using logistic regression we investigated factors associated with agreement between self-reported vaccination status and serological results.
  
  Results
  
  Demographic and other characteristics varied significantly across the 4 groups. Overall agreement between self-reported HepA receipt and serological results was 63.6% (95% confidence interval [CI] 61.9–65.2); PPV and NPV of self-reported vaccination status for serological result were 47.0% (95% CI 44.2–49.8) and 69.4% (95% CI 67.0–71.8), respectively. Mexican American and foreign-born adults had the highest PPVs (71.5% [95% CI 65.9–76.5], and 75.8% [95% CI 71.4–79.7]) and the lowest NPVs (21.8% [95% CI 18.5–25.4], and 20.0% [95% CI 17.2–23.1]), respectively. Young (ages 20–29 years), US-born, and non-Hispanic White adults had the lowest PPVs (37.9% [95% CI 34.5–41.5], 39.1% [95% CI, 36.0–42.3], and 39.8% [36.1–43.7]), and the highest NPVs (76.9% [95% CI 72.2–81.0, 78.5% [95% CI 76.5–80.4)], and 80.6% [95% CI 78.2–82.8), respectively. Multivariate logistic analyses found age, race/ethnicity, education, place of birth and income to be significantly associated with agreement between self-reported vaccination status and serological results.
  
  Conclusions
  
  When assessing hepatitis A protection, self-report of not having received HepA was most likely to identify persons at risk for hepatitis A infection (no anti-HAV) among young, US-born and non-Hispanic White adults, and self-report of HepA receipt was least likely to be reliable among adults with the same characteristics.
  
  
• Subjects:
  Adult Aged Aged, 80 And Over Female Hepatitis A Hepatitis A Antibodies Hepatitis A Vaccines Humans Male Middle Aged Nutrition Surveys Self Report Young Adult

  More +
• Keywords:
  Concordance Hepatitis A Vaccine (HepA) Predictive Value Self-report Serological Testing Vaccination Status
• Source:
  Vaccine. 33(32):3887-3893
• Pubmed ID:
  26116252
• Pubmed Central ID:
  PMC4568740
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Place as Subject:
  United States
• Volume:
  33
• Issue:
  32
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:0e0d91c1d3cf2fb04c7d15959b08061050785ad659cb977353902173088b34de
• Download URL:
  https://stacks.cdc.gov/view/cdc/34281/cdc_34281_DS1.pdf
• File Type:
  [PDF - 329.79 KB ]