PMID- 36588006 OWN - NLM STAT- MEDLINE DCOM- 20230124 LR - 20231117 IS - 1873-2518 (Electronic) IS - 0264-410X (Linking) VI - 41 IP - 4 DP - 2023 Jan 23 TI - Significant gaps in hepatitis B vaccination in adults in Viet Nam: Important targets toward hepatitis B elimination by 2030. PG - 976-988 LID - S0264-410X(22)01577-8 [pii] LID - 10.1016/j.vaccine.2022.12.051 [doi] AB - BACKGROUND: Gaps in adult hepatitis B vaccination were undefined in Vietnam, a lower-middle-income country. To address these gaps, this study defined hepatitis B vaccine coverage in adults and its associated factors in Ho Chi Minh City (HCMC), Viet Nam. We also proposed interventional strategies, prioritizing gap identification to facilitate hepatitis B elimination by 2030 and beyond. METHOD: During 2019-2020, a multi-stage cluster serosurvey with probability proportional to size was conducted to representatively invite 20,000 adults (18 years or older) throughout HCMC for hepatitis B screening (HBsAg, anti-HBs, and anti-HBc). Serologic results defined two dependent variables: vaccine-induced immunity (i.e., isolated anti-HBs) and susceptibility (i.e., HBV naive). Associations of dependent variables with surveyed demographics, socioeconomic statuses, behaviors, and medical history at risk for hepatitis B were evaluated using weighted Poisson regression. RESULTS: The prevalence was 18.5% (95%CI, 17.3-20.0%) for vaccine-induced immunity and 37.7% (35.6-39.8%) for susceptibility. Even though analyses in the general population revealed a falling trend in vaccine-induced immunity prevalence from younger to older age groups, sensitivity analyses in the non-infected population (i.e., those who were both negative for HBsAg and anti-HBc) showed that younger age groups, especially those aged 30 to 50 years, had the lowest prevalence. Social inequalities existed in different ethnicities, residence areas, education levels, house ownership, and health insurance statuses. There was no significant association between vaccine-induced immunity or susceptibility and risky behaviors and medical histories. CONCLUSION: This study depicts a significant unmet need for hepatitis B vaccination in the general adult population in HCMC, Viet Nam. Indeed, the lack of vaccination was unevenly distributed regarding age groups, geographical areas, and socioeconomic statuses, which reveals profound social disparities. Therefore, to achieve hepatitis B elimination goals, besides the current recommendations for infants and risk-based strategies, hepatitis B vaccination should be recommended for the broader population. CI - Copyright (c) 2022 Elsevier Ltd. All rights reserved. FAU - Kim, Thanh V AU - Kim TV AD - Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam; International Health Program, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. Electronic address: thanhkv@pnt.edu.vn. FAU - Pham, Trang N D AU - Pham TND AD - School of Public health, University of Illinois at Chicago, Chicago, IL, USA; Vietnam Viral Hepatitis Alliance, Reston, VA, USA. Electronic address: tpham30@uic.edu. FAU - Le, Duc H AU - Le DH AD - Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam. Electronic address: duclh@pnt.edu.vn. FAU - Dao, Diem V B AU - Dao DVB AD - Vietnam Viral Hepatitis Alliance, Reston, VA, USA. Electronic address: diemdao@vvha.org. FAU - Phan, Loc T B AU - Phan LTB AD - Vietnam Viral Hepatitis Alliance, Reston, VA, USA. Electronic address: locphan@vvha.org. FAU - Le, Anh AU - Le A AD - Vietnam Viral Hepatitis Alliance, Reston, VA, USA. Electronic address: anhle@vvha.org. FAU - Trang, Amy AU - Trang A AD - Vietnam Viral Hepatitis Alliance, Reston, VA, USA. Electronic address: amytrang@vvha.org. FAU - Tang, Hong K AU - Tang HK AD - Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam. Electronic address: hong.tang@pnt.edu.vn. FAU - Liu, Jason J AU - Liu JJ AD - International Health Program, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan. Electronic address: jasonjliu.jjl@gmail.com. FAU - Dao, Doan Y AU - Dao DY AD - Vietnam Viral Hepatitis Alliance, Reston, VA, USA; Center of Excellence for Liver Disease in Viet Nam, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: ddoa1@jhmi.edu. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230102 PL - Netherlands TA - Vaccine JT - Vaccine JID - 8406899 RN - 0 (Hepatitis B Surface Antigens) RN - 0 (Hepatitis B Vaccines) RN - 0 (Hepatitis B Antibodies) SB - IM MH - Infant MH - Adult MH - Humans MH - Aged MH - *Hepatitis B Surface Antigens MH - Vietnam/epidemiology MH - *Hepatitis B/epidemiology/prevention & control MH - Hepatitis B Vaccines MH - Vaccination/methods MH - Hepatitis B Antibodies OTO - NOTNLM OT - Adult OT - Elimination OT - Hepatitis B virus OT - Lower-middle-income country OT - Survey OT - Vaccination OT - Viet Nam COIS- Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2023/01/02 06:00 MHDA- 2023/01/25 06:00 CRDT- 2023/01/01 21:53 PHST- 2022/10/02 00:00 [received] PHST- 2022/11/21 00:00 [revised] PHST- 2022/12/20 00:00 [accepted] PHST- 2023/01/02 06:00 [pubmed] PHST- 2023/01/25 06:00 [medline] PHST- 2023/01/01 21:53 [entrez] AID - S0264-410X(22)01577-8 [pii] AID - 10.1016/j.vaccine.2022.12.051 [doi] PST - ppublish SO - Vaccine. 2023 Jan 23;41(4):976-988. doi: 10.1016/j.vaccine.2022.12.051. Epub 2023 Jan 2.