Low Hepatitis B vaccination coverage in New Delhi, India: urgent call for Universal Adult Hepatitis B vaccination

Eliminating Hepatitis B by 2030 is achievable through vaccination. However, despite the safety of the Hepatitis B vaccine, vaccination coverage among adults in India is suboptimal.

From April 2021 to August 2022, a study in New Delhi, India assessed Hepatitis B vaccination status, willingness to be vaccinated, and awareness of vaccination importance among adults.

7,097 participants (mean age ± SD = 43.3 ± 14 years; range = 18-99 years) were screened. 93.3% of participants reported not receiving even a single dose of the Hepatitis B vaccine. Only 4.4% of the participants were completely vaccinated for Hepatitis B. On Binomial Logistic Regression, we found that as the age increase [Exp(b) = 4.09; 95% CI = 2.061-8.148; p < 0.001], females [Exp(b) = 1.327; 95% CI = 1.056-1.667; p = 0.015], married [Exp(b) = 5.891; 95% CI = 4.610-7.528; p < 0.001], illiterate [Exp(b) = 30.085; 95% CI = 13.307-68.020; p < 0.001], employed [Exp(b) = 1.966; 95% CI = 1.471-2.629; p < 0.001], Muslim population [Exp(b) = 3.031; 95% CI = 1.552-5.917; p = 0.001], monthly salary < 10,000 INR [Exp(b) = 9.580; 95% CI = 6.172-14.872; p < 0.001] are significantly less likely to have completed Hepatitis B vaccination. Most respondents (85.5%) were willing to receive Hepatitis B vaccination, whereas only 25% knew that Hepatitis B vaccination was an effective way to prevent and control Hepatitis B.

Targeted policies and programs are needed to improve low vaccination rates among older adults in India. The Advisory Committee on Immunization Practices recommends Universal Adult Hepatitis B vaccination, which can eliminate the need for risk factor screening, increase vaccination coverage, and reduce Hepatitis B cases.