Department of Community Medicine, IMS & SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, India.
School of Public Health, KIIT Deemed to be University, Bhubaneswar, India.
Asian Pac J Cancer Prev. 2020 Dec 1;21(12):3453-3459. doi: 10.31557/APJCP.2020.21.12.3453.
Elimination of viral hepatitis by 2030 as one of the international Sustainable Development Goals puts the hepatitis B vaccination on the forefront. However, barriers to vaccination reported in various studies are of concern. This study explores the global barriers for effective uptake of Hepatitis-B vaccination.
A scoping review of studies reporting hepatitis B vaccination barriers was done using PMC data base and Google scholar search engine. About 803 journal articles and reports on hepatitis B barriers were retrieved but only 36 most relevant items during last 10 years were identified, pile sorted, grouped and analyze.
Overall 74 barriers have been identified for effective uptake of hepatitis-B vaccines. Most studies focused on non-zero dose of hepatitis B vaccine, One-third of the barriers are related to system issues, one-fourth of the barriers were related to caregiver education or awareness, fear of side effect, migration etc., one-fifth barriers were related to service provider issues like poor out-reach, home visits, poor communication and/relation with the caregivers, failure to identify unimmunized children etc., and other barriers were social-cultural issues. The review reveals limited availability and accessibility to health-facility based immunization, lack of awareness among caregivers, poor communication by the healthcare workers and negative relationships with the beneficiaries, cost of vaccine in private sector, inconvenience time and place of vaccination etc. as the major barriers for hepatitis B vaccination. Barriers varied from country to country.
Myriad barriers for reduced hepatitis-B vaccine uptake need to be addressed contextually as countries are at different stages of hepatitis-B vaccination implementation.
作为国际可持续发展目标之一,到 2030 年消除病毒性肝炎,这使得乙肝疫苗接种成为重中之重。然而,在各种研究中报告的疫苗接种障碍令人担忧。本研究探讨了全球范围内有效实施乙型肝炎疫苗接种的障碍。
使用 PMC 数据库和 Google 学术搜索引擎对报告乙型肝炎疫苗接种障碍的研究进行了范围界定审查。共检索到约 803 篇关于乙型肝炎障碍的期刊文章和报告,但仅确定了过去 10 年中最相关的 36 项,对其进行堆积排序、分组和分析。
总体而言,已确定 74 项有效实施乙型肝炎疫苗接种的障碍。大多数研究集中在乙肝疫苗的非零剂量上,三分之一的障碍与系统问题有关,四分之一的障碍与照顾者的教育或意识、对副作用的恐惧、移民等有关,五分之一的障碍与服务提供者有关,如外联工作不佳、家访、沟通和/与照顾者的关系不佳、未能发现未免疫儿童等,其他障碍与社会文化问题有关。审查结果显示,基于卫生机构的免疫接种的可及性和可获得性有限,照顾者缺乏意识,卫生工作者沟通不畅,与受益人关系紧张,私营部门疫苗费用高,接种时间和地点不便等,这些都是乙型肝炎疫苗接种的主要障碍。障碍因国家而异。
由于各国处于乙型肝炎疫苗接种实施的不同阶段,需要针对减少乙型肝炎疫苗接种的诸多障碍进行有针对性的处理。