Disparities in Hepatitis B Vaccine Coverage by Race/Ethnicity: The National Health and Nutrition Examination Survey (NHANES) 2015–2016

Abstract

Hepatitis B virus (HBV) infection is the most common form of viral hepatitis and remains a global public health problem, even though the HBV vaccine is available. HBV leads to chronic liver disease, including cirrhosis, liver cancer, and death. This study aimed to identify disparities in HBV vaccine coverage with the serological test by race/ethnicity, adjusting for gender and age. In this study, 5735 adult participants were included, obtaining data from the National Health and Nutrition Examination Survey (NHANES), 2015–2016. Proc survey frequency, bivariate- and multivariate logistic regression in the weighted sample were performed due to the complex survey design of NHANES. Data were analyzed using SAS, version 9.2.4. The overall prevalence of HBV vaccine coverage was only 23.3% (95% CI: 20.7%, 25.9%). In a multivariate logistic regression model, data showed that Mexican Americans (OR 0.57, 95% CI: 0.38, 0.86) and African Americans (OR 0.70, 95% CI 0.56, 0.84) had lower vaccine coverage compared to Whites. Females had (OR 1.55, 95% CI: 1.30, 1.85) higher vaccine coverage compared to men. Older age groups (30–49 years) (OR 0.41, 95% CI: 0.32, 0.52) and age group ≥ 50 years (OR 0.18, 95% CI 0.14, 0.23) had lower vaccine coverage compared to younger adults aged 18–29 years.

Vaccine confidence among people who use drugs: A cross-sectional survey

“…Given the extent of liver disease among PWUD, especially among older, racially/ethnically diverse men, the observed effect may correspond with ambivalent VC views associated with HepB vaccination to prevent chronic disease associated with infection. 76 , 77 Thus, these findings offer insight on the sensitivity of our EVCI measures to detect vaccine-specific nuances affecting VC, uniquely shaped by lifetime experiences. Additionally, while VC was positively associated with vaccine receipt, the effect of vaccine confidence on receipt was not as stark as found among parents’ VC and childhood vaccination.…”

Examining the Hepatitis B Care Cascade Through an Equity Lens

“…According to the Centers for Disease Control and Prevention Viral Hepatitis Surveillance Report, Black people are 3.9 times more likely to have chronic HBV and 2.5 times more likely to die from this infection than White people . These data may be less surprising when we consider the lower rates of HBV screening, vaccination, and clinical evaluation reported among Black individuals compared with other groups in the US . The fact that we have not observed racial disparities in treatment initiation does not mean none exist; it means we have to look harder to find them.…”

“…2 These data may be less surprising when we consider the lower rates of HBV screening, vaccination, and clinical evaluation reported among Black individuals compared with other groups in the US. [3][4][5] The fact that we have not observed racial disparities in treatment initiation does not mean none exist; it means we have to look harder to find them.…”

Social Inequities in the Survival of Liver Cancer: A Nationwide Cohort Study in Korea, 2007–2017

“…Finally, several earlier studies reported that social inequalities in HBV vaccination, inequalities in healthcare access, and increases in private insurance system participation in Korea could also affect social inequalities and, consequently, liver cancer deaths in Korea. Social differences in HBV vaccination rates in Korea 27 and around the world 28 29 30 31 were closely related to social inequality in mortality from liver cancer.…”