Baseline hepatitis B vaccination coverage among persons with diabetes before implementing a U.S. recommendation for vaccination
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Baseline hepatitis B vaccination coverage among persons with diabetes before implementing a U.S. recommendation for vaccination

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      Recent data suggest that adults with diabetes are at increased risk of incident hepatitis B infection and may suffer increased morbidity or mortality from chronic hepatitis B infection. In October 2011, the Advisory Committee on Immunization Practices (ACIP) recommended hepatitis B vaccination (HepB) for persons with diabetes aged 19–59 years and stated that persons with diabetes aged 60 years and older should be considered for vaccination.


      To determine HepB coverage among persons with diabetes aged ≥19 years prior to implementation of the new ACIP recommendation and to determine predictors for vaccination.


      We used the 2009 National Health Interview Survey to determine weighted proportions of self-reported HepB coverage (≥1 and ≥3 doses) among persons with diabetes aged ≥19 years. A multivariable logistic regression analysis was performed to determine factors independently associated with vaccination.


      Overall, 19.5% (95% CI: 17.4–21.6%) and 16.6% (14.7–18.6%) of persons with diabetes, aged ≥19 years, reported receiving ≥1 and ≥3 doses of HepB, respectively, compared with 30.3% (29.4–31.3%) and 26.5% (25.5–27.4%) among persons without diabetes. While unadjusted HepB coverage was higher among persons without diabetes, diabetes status was not associated with ≥1 or ≥3 dose vaccination. Among persons with diabetes, being a healthcare provider (OR 4.2, 2.5–7.0), ever tested for HIV (OR 2.6, 1.8–3.6), high-risk behaviors (OR 1.8, 1.0–3.4, P-value = 0.053) and having some college education (OR 1.7, 1.2–2.4) were all independently associated with vaccination.


      HepB coverage among persons with diabetes is low. These data can be used to provide a baseline for measuring future progress toward vaccination of persons with diabetes.

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