Kim S C, Sinai L N, Casey R, Pinto-Martin J A
Division of General Pediatrics, Children's Hospital of Philadelphia, PA 19104, USA.
Pediatrics. 1995 May;95(5):764-6.
To determine the practices of US nurseries, neonatal intensive care units (NICUs), and pediatricians regarding universal hepatitis B vaccination.
Descriptive cross-sectional survey.
One hundred forty term nurseries, 152 NICUs, and 157 pediatricians. Selection procedure. Nurseries and NICUs were systematically sampled from the 1992 American Hospital Association Guide to provide equal sampling from each region of the country. Pediatricians were systematically sampled from a national list of practicing pediatricians supplied by Ross Laboratories to provide equal sampling from each state.
The response rates were 95% (n = 133) for term nurseries, 95% (n = 144) for NICUs, and 83% (n = 131) for pediatricians. Sixty-two nurseries (47%) provide routine hepatitis B vaccine (HBV) to their infants. Eighty-five NICUs (59%) routinely vaccinate their preterm infants; 62 (73%) initiate the series just before discharge; and 11 (13%) do so at birth. Principal reasons for not vaccinating include cost and a preference to allow the primary-care physician to initiate the series. One hundred ten (85%) pediatricians provide universal hepatitis B vaccination. Principal reasons for not vaccinating include cost and parents opting against vaccination.
More than half of NICUs provide HBV routinely to their preterm infants, predominantly just before hospital discharge. A minority of NICUs are initiating vaccination at birth, which may provide suboptimal seroconversion. Although less than half of participating term nurseries are routinely vaccinating before discharge, 85% of pediatricians do initiate HBV by two months of age. The principal reasons for not providing vaccine are financial.
确定美国托儿所、新生儿重症监护病房（NICU）及儿科医生在普遍接种乙型肝炎疫苗方面的做法。
描述性横断面调查。
140个足月儿托儿所、152个NICU及157名儿科医生。选择程序。托儿所和NICU从1992年美国医院协会指南中进行系统抽样，以确保从美国各地区进行平等抽样。儿科医生从Ross实验室提供的全国执业儿科医生名单中进行系统抽样，以确保从每个州进行平等抽样。
足月儿托儿所的回应率为95%（n = 133），NICU为95%（n = 144），儿科医生为83%（n = 131）。62家托儿所（47%）为其婴儿常规接种乙型肝炎疫苗（HBV）。85家NICU（59%）为其早产儿常规接种疫苗；62家（73%）在即将出院前开始接种该系列疫苗；11家（13%）在出生时接种。不接种疫苗的主要原因包括成本以及倾向于让初级保健医生开始接种该系列疫苗。110名（85%）儿科医生提供普遍的乙型肝炎疫苗接种。不接种疫苗的主要原因包括成本以及家长选择不接种。
超过一半的NICU为其早产儿常规接种HBV，主要是在即将出院前。少数NICU在出生时开始接种疫苗，这可能导致血清转化率不理想。虽然不到一半的参与调查的足月儿托儿所会在出院前常规接种疫苗，但85%的儿科医生会在婴儿两个月大时开始接种HBV。不提供疫苗的主要原因是经济方面的。
