Persistence of antibodies and immune memory space to hepatitis B vaccine 20 years after infant vaccination in Thailand. are more likely than adults to become Tubulysin A chronically infected, placing them at risk for potentially fatal liver disease. Disruption of child years transmissionboth maternal-child and child-childis a global health priority.1 The primary tool is the HBV vaccine. Following its intro in 1981 to 1982, the HBV vaccine was slowly integrated into national vaccine plans. Many highly endemic nations in sub-Saharan Africa and Southeast Asia were unable to introduce common child years HBV vaccination until the 2000s. As a result, vaccination protection in countries with endemic HBV varies widely.1,2 Thailand incorporated the vaccine in its Expanded System on Immunization (EPI) in 1992, and by 1995, more than 90% of the 1-year-old children in that country had received the 3-dose series.2 As a result, the prevalence of HBV illness among these children declined from 4.3% (prevaccine era) to 0.7%.3 By contrast, neighboring Burma (also known as Myanmar) did not introduce the vaccine until 2005, and in 2012, only 58% of the 1-year-old children in that country had completed the series.2 HBV vaccination among refugee children has not been well explained, and it cannot be assumed that refugees have experienced improvements in protection. Refugees are often geographically or socially marginalized, compromising access to mainstream health solutions.4C6 Child years vaccine programs may be disrupted by conflict (e.g., Syria) or restrictions on movement (e.g., the Rohingya in Myanmar).7 After fleeing their homes, refugee children do not always have access to national health solutions. Frequently, health care both within and outside of camps is definitely instead coordinated through nonprofit companies. Furthermore, refugees have no vaccine requirement for entry into the United States. Nonetheless, recent studies indicate that HBV illness has become less common, suggesting that HBV vaccination offers improved actually among this marginalized human population. 8 We describe the prevalence of HBV vaccination among refugee children resettled in Minnesota; Philadelphia, Pennsylvania; and Washington State from 2006 to 2012. We hypothesized the inclusion of HBV vaccine in EPIs was associated with higher rates of HBV vaccination among refugee children. We examined HBV serology results for children created before and after the inclusion of the vaccine in national EPIs to test this hypothesis. METHODS With this retrospective study, we used general public health monitoring data from 3 refugee health programs that Tubulysin A have implemented the Centers for Disease Control and Prevention refugee home medical examination, which includes testing for HBV. The sample comprised children more youthful than 19 years from Bhutan, Myanmar, Ethiopia, Iraq, Laos, and Somalia with total data for hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs), antibody to hepatitis B core antigen (anti-HBc), and country of birth (n?=?2291). Children with bad HBsAg, bad anti-HBc, and positive anti-HBs were classified as vaccinated. To verify that children with total serology results did not constitute a biased sample at higher risk for HBV, we used the 2 2 test and logistic regression to compare children with total and incomplete results (data available like a product to the online version of this article at http://www.ajph.org). Children with incomplete serology results were more likely to have arrived in the United States from 2006 to 2008, when most screening protocols did not include anti-HBs or anti-HBc. The prevalence GCN5 of positive HBsAg was similar (3.0% of Tubulysin A children with incomplete serology results and 3.3% of those with complete results). We used logistic regression to describe the connection between serology results and whether children.