Race/ethnicity and gender disparities in the utilization of a school-based hepatitis B immunization initiative

Objective: To determine if participation and completion rates in a school-based hepatitis B vaccination program differ based on individual demographic factors including insurance status, race, and gender. Methods: From 1998 through 2001, a school-based adolescent hepatitis B immunization initiative targeted elementary schools with a high percentage of free lunch and "at risk" students and provided free hepatitis B immunization (0,1, and 4 month schedule) during school hours. Demographic data were collected regarding potential enrollees in the project. The rate of return of consent/ refusal forms, participation rates, and immunization completion rates were determined. Analyses were completed using the z statistic, frequencies, and stratified Chi-square analyses. Results: Families of female children (p <.0001) and those with insurance or Medicaid were more likely than those with no insurance (p <.0001) to respond by returning a consent or refusal form and were also more likely to participate in the program by receiving at least one immunization dose (p <.0001 for both analyses). Participation rates also varied by race (p <.0001) with black and Hispanic potential enrollees participating more frequently than white and Asian potential enrollees. Females among black (p =.012) and Hispanic (p <.0001) participants and participants of Asian race/ethnicity (p <.0001) were more likely to complete the vaccination series. Conclusions: Even when access issues are eliminated as a potential barrier to hepatitis B immunization, gender and race disparities exist in the participation in, and