1. Trends in Hepatitis B Vaccine Coverage and Acute Hepatitis B Incidence among Adolescents in California
Elisha Larez and Celia Woodfill California Department of Health Services, Immunization Branch
March 2006

2. California Immunization Requirements for Hep B Vaccine
1997: 3 doses of Hep B vaccine were required for entry into licensed child care and kindergarten
1999: 3 doses of Hep B vaccine (or the 2 dose adolescent formulation) were required for entry into 7th Grade
Statewide more than 450,000 7th grade students were subject to this requirement

3. California Promotions & Campaigns for Adolescent Recommendations
Adolescent IZ Marketing Plan
Preteen Vaccine Week
California School Nurses Organization (CSNO) Partnership
Back to School 1999 Campaign

4. California Hep B Campaigns & Activities for Adolescents
Movie Ad Campaign
Vaccinate Before You Graduate Campaign
College Informing Campaign
Preteen Vaccine Week

5. Study Objectives
To examine trends in Hep B vaccine coverage and acute Hep B incidence among adolescents, following implementation of a 7th Grade school entry requirement in California

6. Study Methods
Yearly trends of Hep B vaccine coverage among 7th Grade students were analyzed using school assessment data reported from
Yearly trends of Hep B doses given to year olds in public clinics were analyzed using vaccine usage data reported from
Yearly trends of acute Hep B incidence among year olds were analyzed using disease surveillance data reported from

7. Percent of 7th Grade Students Immunized, California 1999-2003

8. 3+ Hep B Vaccine Coverage Among 7th Grade Students, California 1999-2003

9. Doses of Hep B Vaccine Given to 10-14 year olds in Public Clinics, California 1994-2005
7th Grade Requirements
Adolescent Campaigns

10. Estimated 3+ Hep B Vaccine Coverage by Age, California 2005

11. Cases and Rates of Acute Hep B in 12-18 year olds, California 1994-2005
Adolescent Campaigns
7th Grade Requirements

12. Study Conclusions & Next Steps
Hep B vaccine coverage is on the rise and acute Hep B incidence is declining among adolescents in California
Findings have important implications for vaccines targeted for adolescents
Further research needed to determine acceptability of using laws requiring adolescent vaccination