Baseline hepatitis B vaccination coverage among persons with diabetes before implementing a US recommendation for vaccination

Background: 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. Objective: 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. Methods: 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. Results: 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. Conclusion: 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. Published by Elsevier Ltd.