Maxine M. Denniston, R. Monina Klevens, and Ruth B. Jiles are with the Epidemiology and Surveillance Branch, Kathy K. Byrd is with the Prevention Branch, and Jan Drobeniuc and Saleem Kamili are with the Laboratory Branch, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Am J Public Health. 2013 Oct;103(10):1865-73. doi: 10.2105/AJPH.2013.301313. Epub 2013 Aug 15.
We sought to assess the performance of self-reported vaccination with hepatitis B vaccine (HepB) compared with serological status for hepatitis B markers in the general US civilian population.
Using 1999 through 2008 National Health and Nutrition Examination Survey data, we calculated 3 measures of agreement between self-reported HepB vaccination status and serological status: percent concordance, and positive (PPV) and negative predictive values (NPV) of self-report. Logistic regression was used to identify factors associated with agreement between self-report and serological status.
Overall agreement was 83% (95% CI = 82.3, 83.7), NPV of self-report was high (0.95; 95% CI = 0.93, 0.95) and PPV was low (0.53; 95% CI = 0.51, 0.54). Birth year relative to the 1991 recommendation for universal infant HepB vaccination had a strong association with agreement, however, the association was positive for those who reported receiving at least 3 doses and negative for those who reported receiving no doses.
Although the low PPV in our study could be attributable in part to waning of vaccine-induced anti-HBs over time, national adult HepB vaccination coverage may be lower than previously estimated because national estimates usually depend on self-report of vaccine receipt.
我们旨在评估美国普通人群中，自我报告的乙型肝炎疫苗（HepB）接种情况与乙型肝炎标志物血清学状态之间的一致性。
利用 1999 年至 2008 年全国健康和营养调查的数据，我们计算了自我报告的 HepB 疫苗接种状态与血清学状态之间的 3 种一致性衡量标准：百分比一致性、自我报告的阳性预测值（PPV）和阴性预测值（NPV）。采用逻辑回归识别与自我报告和血清学状态之间一致性相关的因素。
总体一致性为 83%（95%CI=82.3，83.7），自我报告的 NPV 较高（0.95；95%CI=0.93，0.95），PPV 较低（0.53；95%CI=0.51，0.54）。与 1991 年推荐普遍对婴儿进行乙型肝炎疫苗接种的年份相比，出生年份与自我报告之间的一致性具有很强的关联，但对于那些报告至少接种 3 剂的人来说，这种关联是积极的，而对于那些报告未接种任何剂量的人来说，这种关联是消极的。
尽管我们研究中的低 PPV 部分可能归因于疫苗诱导的抗-HBs 随时间推移而减弱，但由于国家估计通常依赖于疫苗接种的自我报告，因此全国性的成人乙型肝炎疫苗接种覆盖率可能低于先前估计。
