Vaccination coverage and its determinants of live attenuated hepatitis A vaccine among children aged 24–59 months in 20 rural counties of 10 provinces of China in 2016

Abstract

Objective: To understand one single dose coverage of live attenuated hepatitis A vaccine and its determinants among children aged 24-59 months in 20 rural counties of 10 provinces of China in 2016. Methods: In 20 counties, using three-stage probability proportion to size sampling, 1979 children aged 24-59 months with a vaccination card were selected from 20 rural counties in 2016. Socio-demographic and socio-economic characteristics of children and their caregivers were acquired from face-to-face questionnaire survey and copies of the vaccination cards. We used multivariate logistic regression models to identify the determinants of one single dose coverage of live attenuated hepatitis A vaccine. Results: In 2016, the overall one single dose coverage of live attenuated hepatitis A vaccine among children aged 24-59 months in rural areas of China was 77.1%. The adjusted analysis showed that being in second birth order (adjusted OR: 1.40; 95%CI: 1.03-1.90), being in third birth order or more (adjusted OR: 2.10; 95%CI: 1.26-3.51), being born at home (adjusted OR: 2.01; 95%CI: 1.04-3.88) and having the lowest per capita income of household (adjusted OR: 2.36; 95%CI: 1.11-4.99) were significantly related to being unvaccinated one single dose coverage of live attenuated hepatitis A vaccine against hepatitis A virus. Conclusion: one single dose coverage of live attenuated hepatitis A vaccine was still at a low level in 20 rural counties of 10 provinces in China. To improve the coverage of live attenuated hepatitis A vaccine, the government should pay more attention to the disadvantaged groups, especially the children who were in second birth order or higher, or delivered at home, or who have the lowest per capita income of household.

Epidemiologic trends of hepatitis A in different age groups and regions of China from 1990 to 2018: observational population-based study

“…Nevertheless, hepatitis A was relatively common among older adults (>50 years old) and preschool children (1–5 years old) in 2016. We can suggest four possible explanations for this: (i) the national HAV vaccination programme for newborns and catch-up vaccinations for children provided inadequate protection of older adults [28]; (ii) the weaker immune responses of young children and older adults makes them more vulnerable to infection; (iii) there was a low vaccination rate among children in some rural regions [29] and (iv) insufficiency of specific hygienic measures for children in institutions such as nurseries [30] and schools. Since HAV is transmitted via the faecal–oral route, high hepatitis A infection can be contributed by inadequate habits of hygiene, intensive contact and susceptibility in children [31].…”