Hepatitis B vaccination initiation and vaccination series completion: An in-depth systematic evidence review, with meta-analysis of associations with individual socioeconomic and health-related factors

Abstract

Background: Associations between hepatitis B vaccination and individual socioeconomic/health-related factors have not been summarised.

Methods: We conducted a systematic review with meta-analysis (PROSPERO: CRD42023445721) wherein we grouped study populations into a paediatric population (<18-year-olds), community-dwelling adults (≥18-year-olds of average risk), persons at a higher risk of exposure, and persons with a chronic condition(s). We pooled appropriate multivariable-adjusted results using an inverse variance random-effects model, with the pooled results expressed as odds ratios and associated 95% confidence intervals.

Results: We included 83 cross-sectional studies. Thirty-nine studies reported on vaccination initiation, and 51 reported on vaccination series completion. In the paediatric population, being a child of an Asian versus White mother increased the odds of vaccination initiation, whereas a low versus high mother's socioeconomic status and birth in a health facility versus home birth increased the odds of vaccination series completion. In community-dwelling adults, there were increased odds of vaccination initiation with being younger, a White versus Black/Hispanic person, a health professional, higher education, HIV/hepatitis B screening, influenza vaccination in the past year, health insurance, and health care utilisation. There were increased odds of vaccination series completion with factors like initiation. In persons at a higher risk of exposure, older age, higher education, HIV/hepatitis B screening, influenza vaccination in the past year, being married/cohabiting, and training on infection increased the odds of vaccination initiation. In contrast, drug use, HIV/hepatitis B screening, being married/cohabiting, being female, being a current/former smoker, and having more health worker experience increased the odds of vaccination series completion. In persons with chronic condition(s), younger age was associated with increased odds of vaccination initiation, whereas higher education and being a health professional increased the odds of vaccination series completion.

Conclusions: Several individual socioeconomic and health-related factors may influence hepatitis B vaccination, particularly in community-dwelling adults and persons at higher risk of exposure. Our findings may inform targeted messaging to optimise hepatitis B vaccination.