Determinants of suboptimal hepatitis B vaccine uptake among men in the Republic of Korea: where should our efforts be focused: results from cross-sectional study

Abstract

BackgroundLiver cancer is the second most-frequent cause of cancer death in Korea. Hepatitis B virus (HBV) infection is a major cause of liver cancer, and this disease is effectively prevented by HBV vaccination. This study was conducted to investigate factors associated with the lack of HBV vaccine uptake in the general adult male population in Korea.MethodsData of men who participated in a nationwide cross-sectional interview survey were analyzed. A total of 2,174 men 40 years of age and older were interviewed between 2006 and 2008. None of the participants was infected with HBV or was experiencing sequelae of an HBV infection.ResultsOnly half (50.4%) of the men received one or more dose of the three-dose series of HBV vaccinations, and 32.5% received all three doses. Compared with men who had completed the vaccination regimen, non-vaccinated men were more likely to lack supplemental medical insurance for cancer (odds ratio = 0.66, 95% confidence interval: 0.52–0.84), have lower incomes (p-trend = 0.010), and be less educated (p-trend = 0.021). Lower education was also more prevalent in the non-vaccinated group compared with the incompletely vaccinated group. Those who had completed the vaccination regimen were likely to be more educated than those in the incompletely vaccinated group (p-trend = 0.044). The most commonly cited reason for not obtaining the HBV vaccine was lack of knowledge regarding the need for the vaccination. The number of men who cited this reason decreased as a function of education.ConclusionsIt is important to develop strategic interventions targeted at less-educated men to increase uptake of a complete three-dose series of HBV vaccinations as a primary approach to preventing liver cancer.

Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission

“…Despite strong progress in HBV vaccine coverage, continued efforts are required to maintain and expand coverage. In South Korea, for example, declines in HBV prevalence have been slow despite implementation of universal vaccination in 1992 (only 32.5% of males received all three recommended doses of the vaccine in 2006-8, primarily because of a lack of public awareness about the necessity of vaccination 199 . Provision of the birth dose vaccine has also been problematic for various reasons, including a high proportion (nearly 40%) of home deliveries in some countries, GAVI's insistence on providing only the pentavalent (childhood) vaccine to countries whose immunisation programmes it supports, and lack of HBV testing among pregnant women 200 .…”

Uptake of Mass Drug Administration Programme for Schistosomiasis Control in Koome Islands, Central Uganda

“…Although general level of education has been found to be associated with the uptake of health services [ 22 , 25 , 28 ] because it facilitates understanding of health education messages, it was not a relevant factor in this study.…”

Hepatitis A and hepatitis B vaccination coverage among adults with chronic liver disease

“…Travelers to countries with high or intermediate endemicity of hepatitis A have been recommended to be vaccinated with HepA vaccine since 1996 [23]. The association between coverage and educational level might be indicative of increased information-seeking behavior and a better understanding of the need of vaccination among more educated persons [25]. …”

“…Adults with CLD who had some college or above education had significantly higher coverage compared with those who had less than a high school education. Higher vaccination coverage among adults with higher education levels might be associated with increasing numbers of colleges and universities that require HepB vaccination for college entrance, as well as a better understanding of the need of vaccination [25, 31]. Higher HepB vaccination coverage among those who had influenza vaccination in past twelve months could reflect patients’ or providers’ awareness of the need for vaccinations in general [26, 32].…”