Background
Hepatitis B can be transmitted vertically to newborns and has a 90% chance of becoming a chronic disease. 95% of chronic carriage can be prevented by appropriate vaccination. Our paediatric department is exceptional in following up babies after hepatitis B vaccination. Eligible babies are seen in immunisation clinic till serology blood results confirm appropriate antibodies response. This re-audit’s aim was to measure performance in hepatitis B vaccination coverage against local guidelines for antenatal and postnatal care of babies who received vaccination. Results were compared with previous audit (04/2006-12/2008).

Methods
Retrospective cohort review of neonates born between 01/01/2014-01/03/2016 who received hepatitis B vaccination before discharge as per local policy. Data identified by review of positively screened mothers from antenatal screening and cross-checked with data from immunisation paediatric nurse specialist. Patients' records were subsequently reviewed whether doses and serology blood tests were performed as per protocol.

Results
Total of 25 neonates received hepatitis B vaccination before discharge (01/01/2014-01/03/2016). 100% of all babies born to hepatitis B positive mothers received first dose of vaccination as inpatient. 93.75% of babies born to hepatitis B positive mothers received vaccination in 24 hours. 92% of all eligible babies received 2nd dose, 84% received 3rd dose and 40% received 4th dose. 81% of eligible patients had serology tested. 2 babies (8%) were missed from follow up.

Conclusions
Results showed that designated immunisation nurse increases likelihood of completion of the immunisation program. It is essential to use best efforts to reduce risk of chronic hepatitis B in paediatric population. From 2017 hepatitis B vaccination (Hexavalent DTaP/IPV/Hib/HepB) was introduced to childhood primary immunisation schedule in UK. This will improve coverage and reduce number of babies requiring additional follow up in immunisation clinics.

EFFECTIVENESS OF A DEDICATED HEPATITIS B IMMUNISATION SERVICE IN THE PAEDIATRIC DEPARTMENT IN A DISTRICT GENERAL HOSPITAL IN SOUTHEND, UK - RE-AUDIT