Hepatitis B Virus Status And Vaccination Coverage Among Health Care Workers In Three Provinces Of China

ObjectiveThis study aims to investigate the self-reported prevalence of hepatitis B surface antigen(HBsAg)and hepatitis B vaccination status among HCWs in Fujian,Jiangxi and Gansu province,China,and explores its influencing factors.MethodsWe conducted a cross-sectional survey in 120 hospitals in Fujian,Jiangxi and Gansu province from May to October 2017 among HCWs aged 25-59 years old and with at least six-month working years in hospital.A questionnaire was used to collect information on demographic,HBV infection and vaccination history data.Descriptive analysis was used to describe distribution of HBsAg positivity,hepatitis B vaccination coverage among HCWs with different characteristics and vaccination willingness rate among HCWs.Multivariate logistic regression analysis was used to assess factors associated with HBsAg positivity and hepatitis B vaccination coverage.ResultsThe self-reported HBsAg prevalence among HCWs suerveyed was 13.2%(491/3,728).The HBsAg prevalence in Jiangxi province(OR=0.67,95%CI:0.52-0.86)and Gansu Province(OR=0.72,95%CI:0.56-0.92)were lower than Fujian province.Comparing to municipal-level hospital,working at a county-level(OR=0.79,95%CI:0.63-0.99)or township-level hospital(OR=0.65,95%CI:0.51-0.83)had at least one dose HepB(OR=0.56,95%CI:0.44-0.71)were independently associated with a lower risk of HBV infection.Conversely,HCWs working 5-14 years(OR=1.40,95%CI:1.01-1.94)and working at least 15 years(OR=1.75,95%CI:1.11-2.76)compared to less than 5 years,and having occupational exposure history(OR=1.25,95%CI:1.03-1.52)were independently associated with an increased risk of HBV infection.The self-reported at least one dose hepatitis B vaccination coverage among HCWs was 85.89%(2666/3104).Hepatitis B vaccination coverage in Gansu province(OR=1.48,95%CI:1.05-2.07)was higher than Fujian province.HCWs who were at least 40 years old(OR=0.52,95%CI:0.32-0.85),who worked 5-14 years in their profession(OR=0.63,95%CI:0.43-0.91)and who worked in high-risk departments(OR=0.69,95%CI:0.56-0.86)were associated with a lower vaccination rate.Workplaces offering free hepatitis B vaccine with a vaccination management system(OR=2.18,95%CI:1.41-3.35),receiving training on HBV infection or HepB(OR=1.98,95%CI:1.58-2.49)and working as a nurse(OR=1.35,95%CI 1.01-1.83)were associated with an increased hepatitis B vaccination coverage.Reasons mentioned most for receiving hepatitis B vaccination were "protect myself","protect my family members" and "protect my patients".Reasons mentioned most for not receiving hepatitis B vaccination were "having gained immunity from work","hospitals not providing hepatitis B vaccination activities" and "too busy to be vaccinated".Only 29.9%(131/438)of unvaccinated HCWs intended to receive hepatitis B vaccination.ConclusionThe self-reported HBsAg prevalence among HCWs is high while the complete three doses hepatitis B vaccination rate and their desire for vaccination are low.Working at a higher level hospital,longer working years and occupational exposure experience were risk factors of HBV infection.Lack of hepatitis B vaccination campaigns in hospitals and hepatitis B vaccination recommendation for HCWs from officials may contribute to the low vaccination willingness partly.Health education are needed in all levels of hospitals and a well-managed free national hepatitis B vaccination policy for HCWs should be prioritized to improve hepatitis B coverage in this high risk occupational group.