City's Top Hospitals Fail to Vaccinate Newborns Against Hep B, Study Shows

By Rosa Goldensohn on July 21, 2014 7:46am 

Click to see the vaccination rates for several New York City hospitals

NEW YORK — All babies should receive the hepatitis B vaccination as soon as they're born, federal officials say — but advocates say at some of the city's top hospitals hardly any newborns get the vaccine, putting them at risk of developing the disease.

Two of the hospitals with the lowest vaccination rates in the city are Mount Sinai and Beth Israel, where fewer than 20 percent of babies received the hepatitis B vaccine in 2012, according to Health Department data.

And at Maimonides, Tisch and Roosevelt hospitals, just 20 to 40 percent of newborns got the vaccine that year, data show.

"By not vaccinating babies at birth, they’re putting those newborns at risk," said Dr. Deborah Wexler, executive director of the Immunization Action Coalition, a group that works with the federal government to increase vaccination rates.

"The damage that’s being done by not protecting them at birth can’t be undone. If they become infected, they’re probably infected for the rest of their lives."

The Centers for Disease Control and Prevention, as well as state and city health officials, strongly recommend that all infants receive the hepatitis B vaccine within 12 hours of birth to prevent mothers with the disease from passing it on to their baby.

If babies with infected mothers do not get the vaccine at birth, they have a 90 percent chance of developing chronic hepatitis B, which causes illnesses including chronic liver disease, cirrhosis and liver cancer, according to a New York State report. 

But since the government does not mandate that all infants receive the hepatitis vaccine at birth, New York City's hospitals are allowed to set their own policies, a representative of the city's Health Department said.

“There is not a hepatitis B vaccination requirement for newborns, which is why there is variability in coverage between facilities," the Health Department said in a statement, noting that roughly 60 percent of infants in the city receive the vaccine within three days of birth.

 Federal officials recommend that all newborns receive the hepatitis B vaccine, but at some city hospitals, fewer than 40 percent of babies are innoculated, according to a Health Department presentation.
Federal officials recommend that all newborns receive the hepatitis B vaccine, but at some city hospitals, fewer than 40 percent of babies are innoculated, according to a Health Department presentation.
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Shutterstock/Jovan Mandic

"However, the Health Department encourages health care facilities in New York City to vaccinate all newborns to help protect them from hepatitis B."

Hospitals with low vaccination rates say they give parents the choice of whether their child should be vaccinated, and many prefer to get the vaccine later at their pediatrician's office.

Some pediatricians also have a financial interest in giving the vaccine themselves, because they get to bill for it, according to hospitals and advocates.

"There's also a financial side to that," Eileen Tynion, spokeswoman for Maimonides, said of the hospital's low vaccination rate. "The private pediatricians can bill for administering it."

Erika Hellstrom, a spokeswoman for Richmond University Medical Center on Staten Island, said pediatricians often influence parents' decision.

“We do have pediatricians that prefer that the vaccine be administered in the office and tell their patients that,” said Hellstrom, who added that the hospital vaccinated 40 to 45 percent of newborns in 2013.

At New York Methodist Hospital in Brooklyn, only 37 percent of newborns got the hepatitis B birth vaccine last year, even though hospital leaders are "very interested in encouraging [it]," said Lynn Hill, a hospital spokeswoman.

“I don’t think that they push them either way, but we make very sure that they offer it,” Hill said.  She said many parents seem to "prefer to have a private pediatrician take care of the vaccine.”

But some city hospitals vaccinate nearly all newborns, including St. Barnabas Hospital in The Bronx and Coney Island Hospital in Brooklyn.

At St. Barnabas, nurses are trained to recommend the vaccine to all parents of newborns, said Steven Clark, a hospital spokesman.

"The hepatitis B vaccine at St. Barnabas Hospital is offered to all newborns...and if parents choose, they can opt out," Clark said.

To encourage hospitals to vaccinate more newborns, the state has a program that gives free vaccines to those that have a policy of inoculating all babies. As of last year, 25 of the city's 45 birthing hospitals were enrolled, according to the city's Health Department.

The city and state declined to release a list of those hospitals, but many of the top-vaccinating facilities in the city are public hospitals that are part of the city's Health and Hospitals Corporation, data shows.

Lynn Pollock, the perinatal hepatitis B coordinator for the state's Department of Health, said vaccination rates really come down to how hospitals communicate with parents.

“When the mother is admitted into labor, it’s really important to get that consent form right then," Pollock said. "And the way it’s presented by the nurses: This is the hospital’s policy, the standard of care in New York. It’s the best thing for your baby."

Beth Israel, Mount Sinai and Roosevelt, all Mount Sinai hospitals, did not comment, and neither did Tisch.

Caitlin Wiley, 29, said she remembers a nurse speaking to her about the hepatitis B vaccine after she gave birth recently at Lenox Hill Hospital, where 63 percent of newborns were vaccinated last year.

"They said I could have it done at the hospital or at my pediatrician," Wiley said. "When I asked them which was better or why I would pick one over the other, they responded, 'Some people like to wait.'"

 Some hospitals vaccinate nearly all babies against hepatitis B, but others vaccinate fewer than 20 percent, records show.
Some hospitals vaccinate nearly all babies against hepatitis B, but others vaccinate fewer than 20 percent, records show.
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DNAinfo/Nigel Chiwaya

Wiley decided to request the vaccine but the hospital was busy and it didn't happen, so she got her daughter vaccinated at her pediatrician's office a couple of days later, Wiley said.

Allegra Shmulevsky, 28, of Brooklyn, said when her son was born at Methodist Hospital in January, he was given the vaccine after two residents came to discuss it with her.

“When they offered to do it at the hospital instead of my doctor’s office, I thought that was a positive thing,” Shmulevsky said. “I think the way they framed it was that it was very commonly done before they leave the hospital.”

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