Hepatitis B Vaccination Coverage and Vaccine-Associated Immunity Among US-Born Children and Adolescents: NHANES 2017-2020 – Research

Since the initial recommendations for universal infant hepatitis B vaccination in the United States, vaccination coverage has increased significantly. However, a trend of declining antibody levels has been observed among early vaccinees. This study aims to investigate hepatitis B vaccination coverage and vaccine-associated immunity among US-born children and adolescents. We used data from the 2017-2020 National Health and Nutrition Examination Survey to include US-born participants aged 2 to 18 years who had complete hepatitis B serological data and vaccination history. We determined the prevalence of completing the hepatitis B vaccination series and the prevalence of vaccine-associated immunity. A total of 2,852 US-born children and adolescents were included in the study, achieving a complete hepatitis B vaccination coverage rate of 83.9% (95% CI: 81.5%-86.3%). Among the 2,317 individuals who had complete hepatitis B vaccination series, the vaccine-related immunity rate was 35.2% (95% CI: 32.5%-37.8%). Multivariable logistic regression analysis identified age group, race/ethnicity, family income to poverty ratio, and hepatitis A antibody as significant factors associated with complete vaccination coverage (p < 0.05). Additionally, the hepatitis B surface antibody levels decreased with age (p < 0.05). Hepatitis B vaccination coverage among US-born children and adolescents declined during the 2017-2020 period. Targeted vaccination efforts in underserved populations may help improve vaccination coverage. Future continuous monitoring of trends in both vaccination and seropositivity rates is needed.