Factors Associated with Hepatitis B Vaccination Status Among U.S. Adults with Diabetes

Background/Objectives: Adults aged 19-59 with diabetes are recommended by the Advisory Committee on Immunization Practices (ACIP) to receive vaccination against Hepatitis B Virus (HBV) infection because of their increased risk of contracting HBV. This study aimed to examine hepatitis B (HepB) vaccination rates among U.S. adults aged 19-59 years with diabetes and explore sociodemographic factors associated with HepB vaccination. Methods: Data from the 2015-2018 National Health and Nutrition Examination Survey (NHANES) were analyzed to compare HepB vaccination between adults with and without diabetes. Weighted Chi-square analysis was used to test the associations between HepB vaccination status and various categorical variables. Weighted logistic regression was employed to identify factors associated with being fully vaccinated. Results: A total of 5988 adults aged 19-59 were included in the study, of whom 504 (8.4%) had diabetes. The HepB vaccination rate was 32.3% for those with diabetes vs. 43.6% for those without diabetes (p = 0.01). However, after adjusting for other covariates, having diabetes was not associated with being fully vaccinated against HBV (p = 0.583). Adults aged 45-59 years were less likely to be vaccinated against HBV compared to those aged 19-29 (OR: 0.12, p < 0.0001). Having health insurance, being female, and having a higher educational level were all associated with HepB vaccination status (all p < 0.01). Overall, the HBV infection rate was 1.1%. Having HepB vaccination was associated with a lower risk of HBV infection among both groups with and without diabetes. Conclusions: HepB vaccination among U.S. adults with diabetes was suboptimal and lower than among those without diabetes. Age and education were associated with being fully vaccinated against HBV. Future research is needed to identify and better understand barriers to receiving HepB vaccines.