A HEPATITIS-B VACCINATION PROGRAM TARGETING ADOLESCENTS

Purpose: To determine the effectiveness of using a middle school for hepatitis B vaccination of adolescents. Methods: An immunization program was designed to educate parents and students about hepatitis B virus (HBV) infection and hepatitis B vaccination using science class presentations and mailings. Students were vaccinated in the school-based clinic. Incentives were given at each visit and on vaccination series completion. Costs were calculated and divided by the number of students completing the series to obtain per student cost. Results: Of the 654 students, 519 (79%) received at least one dose of hepatitis B vaccine, 497 (76%) two doses, and 425 (65%) three doses. Student participation did not vary by grade level, gender, or income. Per student vaccination cost was $77.23 for those receiving three doses of hepatitis B vaccine and $66.04 when those receiving at least two doses were included. Of 103 students with postvaccination serologic testing, three had evidence of previous hepatitis B virus infection, four had no evidence of vaccine induced immunity, and 96 (96% of susceptible students) developed protective levels of antibodies against hepatitis B surface antigen. The geometric mean antibody titer among persons responding to vaccination was 661 mIU. Conclusion: Hepatitis B vaccination of adolescents can be successfully integrated into a middle school setting.