Factors associated with uptake of Haemophilus influenzae type b vaccination in Shanghai, China

Haemophilus influenzae type b (Hib) vaccine is effective in reducing the burden of Hib related diseases, but little is known about factors influencing the uptake of Hib vaccine. This study aimed to assess the uptake of Hib vaccination and its associated factors in Shanghai City, China.

We used data from a retrospective cohort of 183,246 children born in 2012-2016 obtained from the Shanghai Immunization Program Information System, which provided information on the uptake of Hib vaccination. We conducted a cross-sectional study of 451 children to collect information on demographic and other factors that might be associated with Hib vaccination.

In the retrospective cohort study, the proportions of Hib dose-1 coverage, vaccination completion and timeliness were 67.7, 52.2 and 29.4%, respectively. These measures were better among local children and increased with birth year, while there were regional differences. Hib vaccine uptake was significantly associated with maternal occupation (non-health vs health workers, OR = 2.33, 95% CI: 1.32-4.13, P = 0.004) and caregivers' awareness of Hib (yes vs no, OR = 1.75, 95% CI: 1.12-2.74, P = 0.013).

We found low levels of coverage of dose-1 Hib vaccine, timeliness and completion, suggesting inadequate protection against Hib disease for children in Shanghai. Non-local children and those of health workers should be targeted for interventions. The inclusion of Hib vaccine into the national immunization program could help improve the uptake of Hib vaccines.