The barriers to neonatal Hepatitis B vaccination in Israel: A prospective study

Background: Opposition to neonatal Hepatitis B vaccination is a growing trend in Israel. Objectives: To assess the sociodemographic factors and attitudes associated with non-vaccination of term singleton newborns. Methods: This prospective, pair-matched, controlled trial was conducted in a tertiary university-affiliated hospital. Data on maternal sociodemographic parameters, delivery, and infant care practices were gathered. Knowledge and references of Hepatitis B virus (HBV) vaccination, vaccination schedule, and health government policies were assessed. A followup telephone survey was completed at the age of 7 weeks postpartum regarding vaccine catch-up rate. Results: Mothers in the study group were mostly Jewish white middle class married multiparous women with some higher education. Hepatitis B serology was not tested in most. Higher rates of rooming-in and exclusive breastfeeding were observed. Knowledge about HBV was stated, multiple sources of information were significantly associated with newborn non-vaccination. Many objected to the timing of the vaccine and its necessity. Multiple medical encounters are viewed as missed opportunities. Conclusions: Multiple sources of vaccine information are associated with non-vaccination. Medical encounters prior and post-delivery should be used for vaccination education and may improve vaccination coverage.