Abstract

Hepatitis B vaccination is widely recognized as the most effective way to prevent hepatitis B infection, yet the rate of complete vaccination among Indonesian children remains low. This study aimed to evaluate the extent of hepatitis B vaccination coverage among children and identify potential associated factors in Indonesia. A community-based cross-sectional study was conducted. The study involved 7,860 Indonesian mothers of children aged 12-59 months, providing data on their children's hepatitis B vaccination status and other relevant factors from the 2017 Indonesian Demographic Health Survey. Overall, the rate of complete hepatitis B vaccination among children was relatively high (89.8%). Several factors were found to be associated with complete hepatitis B vaccination among children: living in Java, the Lesser Sunda Islands, Kalimantan, and Sulawesi compared to Sumatra; having an older mother; having parents with secondary or higher education compared to no education; having an employed mother; belonging to middle or high economic status compared to low economic status; having mothers using media irregularly or regularly, as opposed to never using media; having health insurance; and having a larger family size. These findings highlight the need for further interventions to optimize childhood hepatic vaccination coverage, which health policymakers should support.

References

1. World Health Organization. Hepatitis B. Geneva: World Health Organization; 2024.

2. World Health Organization. World hepatitis day 2020. Geneva: World Health Organization; 2020.

3. Yano Y, Utsumi T, Lusida MI, et al. Hepatitis B virus infection in Indonesia. World J Gastroenterol. 2015; 21 (38): 10714-10720. DOI: 10.3748/wjg.v21.i38.10714.

4. Lusida MI, Juniastuti, Yano Y. Current hepatitis B virus infection situation in Indonesia and its genetic diversity. World J Gastroenterol. 2016; 22 (32): 7264-7274. DOI: 10.3748/wjg.v22.i32.7264.

5. Girawan D, Judistiani RTD, Risan NA, et al. The high prevalence of negative hepatitis B surface antibody (Anti-HBs) among pregnant women in Bandung, Indonesia: A community-based study. Int J Hepatol. 2020; 3414869. DOI: 10.1155/2020/3414869.

6. Badan Penelitian dan Pengembangan Kesehatan. Riset Kesehatan Dasar (Riskesdas) 2013. Jakarta: Kementerian Kesehatan Republik Indonesia; 2013.

7. Muljono DH. Epidemiology of hepatitis B and C in Republic of Indonesia. Euroasian J Hepatogastroenterol. 2017; 7 (1): 55-59. DOI: 10.5005/jp-journals-l0018-1212.

8. Purwono PB, Juniastuti, Amin M, et al. Hepatitis B virus infection in Indonesia 15 years after adoption of a universal infant vaccination program: Possible impacts of low birth dose coverage and a vaccine-escape mutant. Am J Trop Med Hyg. 2016; 95 (3): 674-679. DOI: 10.4269/ajtmh.15-0121.

9. Badan Penelitian dan Pengembangan Kesehatan. Hasil Utama Riset Kesehatan Dasar (Riskesdas) 2018. Jakarta: Kementerian Kesehatan Republik Indonesia; 2018.

10. National Population and Family Planning Board (BKKBN), Statistics Indonesia (BPS), Ministry of Health (Kemenkes), and ICF. Indonesia Demographic and Health Survey 2017. Jakarta, Indonesia: BKKBN, BPS, Kemenkes, and ICF; 2018.

11. Kyuregyan KK, Kichatova VS, Isaeva OV, et al. Coverage with timely administered vaccination against hepatitis B virus and its influence on the prevalence of HBV infection in the regions of different endemicity. Vaccines (Basel). 2021; 9 (2): 82. DOI: 10.3390/vaccines9020082.

12. Mansor-Lefebvre S, Strat YL, Bernadou A, et al. Diphtheria-tetanus-polio, measles-mumps-rubella, and hepatitis B vaccination coverage and associated factors among homeless children in the Paris region in 2013: Results from the ENFAMS survey. Int J Environ Res Public Health. 2020; 17 (8): 1-17. DOI: 10.3390/ijerph17082854.

13. Wilson P, Taylor G, Knowles J, et al. Missed hepatitis B birth dose vaccine is a risk factor for incomplete vaccination at 18 and 24 months. J Infect. 2019; 78 (2): 134-139. DOI: 10.1016/j.jinf.2018.09.014.

14. Machmud PB, Glasauer S, Gayatri D, et al. Mother's media use and children's vaccination status in Indonesia: A community-based cross sectional study. Glob Pediatr Health. 2022; 9: 1-10. DOI: 10.1177/2333794X221092740.

15. Machmud PB, Gayatri D. Complete dose of hepatitis B vaccination among children in Indonesia and factors associated: A community-based cross-sectional study. In: The Asia-Pacific Academic Consortium for Public Health “Enhancing public health strategies during industrial revolution 4.0 and the Covid-19 pandemic (A.355)”; 2021.

16. WorldAtlas. Tujuh wilayah geografis Indonesia. WorldAtlas; 2021.

17. Khan J, Shil A, Mohanty SK. Hepatitis B vaccination coverage across India: Exploring the spatial heterogeneity and contextual determinants. BMC Public Health. 2019; 19: 1263. DOI: 10.1186/s12889-019-7534-2.

18. Nadella P, Smith ER, Muhihi A, et al. Determinants of delayed or incomplete diphtheria-tetanus-pertussis vaccination in parallel urban and rural birth cohorts of 30,956 infants in Tanzania. BMC Infect Dis. 2019; 19: 188. DOI: 10.1186/s12879-019-3828-3.

19. Okenwa UJ, Dairo MD, Bamgboye E, et al. Maternal knowledge and infant uptake of valid hepatitis B vaccine birth dose at routine immunization clinics in Enugu State – Nigeria. Vaccine. 2020; 38 (12): 2734-2740. DOI: 10.1016/j.vaccine.2020.01.044.

20. Tesema GA, Tessema ZT, Tamirat KS, et al. Complete basic childhood vaccination and associated factors among children aged 12–23 months in East Africa: A multilevel analysis of recent demographic and health surveys. BMC Public Health. 2020; 20: 1837. DOI: 10.1186/s12889-020-09965-y.

21. Ueda M, Kondo N, Takada M, et al. Maternal work conditions, socioeconomic and educational status, and vaccination of children: A community-based household survey in Japan. Prev Med. 2014; 66: 17-21. DOI: 10.1016/j.ypmed.2014.05.018.

22. Chen W, Elam-Evans LD, Hill HA, et al. Employment and socioeconomic factors associated with children’s up-to-date vaccination status. Clin Pediatr (Phila). 2017; 56 (4): 348-356. DOI: 10.1177/0009922816660540.

23. Anh HNS, Vo H-L, Bao LH, et al. Hepatitis B birth dose vaccination among Vietnamese children: Implications for the expanded program on immunization. Biomed Res Int. 2019; 2019: 3453105. DOI: 10.1155/2019/3453105.

24. Giao H, Vinh BQ, Lang NHT, et al. Parents’ attitude about hepatitis B disease and practice of hepatitis B vaccination among children in Ho Chi Minh City, Vietnam. Biomed Res Int. 2019; 2019: 9323814. DOI: 10.1155/2019/9323814.

25. Cao L, Zheng J-S, Cao L-S, et al. Factors influencing the routine immunization status of children aged 2-3 years in China. PLoS One. 2018; 13 (10): e0206566. DOI: 10.1371/journal.pone.0206566.

26. Lee CHJ, Overall NC, Sibley CG. Maternal and paternal confidence in vaccine safety: Whose attitudes are predictive of children’s vaccination? 2020; 38 (45): 7057-7062. DOI: 10.1016/j.vaccine.2020.09.020.

27. Hazan G, Dagan R, Friger M. Maternal education is inversely related to vaccination delay among infants and toddlers. Pediatr. 2019; 205: 120-125.e2. DOI: 10.1016/j.jpeds.2018.

28. Erb ML, Erlanger TE, Heininger U. Do fathers care about their own immunisation status? The Child-Parent-Immunisation Survey and a review of the literature. Swiss Med Wkly. 2020; 150: w20289. DOI: 10.4414/smw.2020.20289.

29. Johri M, Subramanian SV, Sylvestre M-P, et al. Association between maternal health literacy and child vaccination in India: A cross-sectional study. J Epidemiol Community Health. 2015; 69 (9): 849-857. DOI: 10.1136/jech-2014-205436.

30. Herliana P, Douiri A. Determinants of immunisation coverage of children aged 12-59 months in Indonesia: A cross-sectional study. BMJ Open. 2017; 7 (12): e015790. DOI: 10.1136/bmjopen-2016-015790.

31. Huynh G, Nguyen TB, Cao NN, et al. Hepatitis B birth dose among children in District 2 Hospital, Ho Chi Minh City, Vietnam: Prevalence and associated factors. Can J Infect Dis Med Microbiol. 2020; 2020: 5680154. DOI: 10.1155/2020/5680154.

32. Awasthi A, Pandey C, Singh U, et al. Maternal determinants of immunization status of children aged 12-23 months in urban slums of Varanasi, India. Clin Epidemiol Glob Health. 2015; 3 (3): 110-116. DOI: 10.1016/j.cegh.2014.07.004.

33. Syiroj AT, Pardosi JF, Heywood AE. Exploring parents’ reasons for incomplete childhood immunisation in Indonesia. Vaccine. 2019; 37 (43): 6486-6493. DOI: 10.1016/j.vaccine.2019.08.081.

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