Bai Xinxin, Chen Lu, Liu Xinyao, Tong Yujia, Wang Lu, Zhou Minru, Li Yanming, Hu Guangyu
School of Public Health, Hebei Medical University, Shijiazhuang 050011, China.
Department of Radiology, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430023, China.
Vaccines (Basel). 2022 Jun 6;10(6):900. doi: 10.3390/vaccines10060900.
The most effective way to prevent hepatitis B virus (HBV) infection is vaccination. Synthesized data on vaccination coverage in adults against hepatitis B in China are scarce. We aimed to estimate the hepatitis B vaccination rate in adults in China.
We searched PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, WanFang, and Sinomed databases for observational studies published between 1 January 2011 and 1 October 2021. Data were extracted using a standardized form to estimate the pooled vaccination coverage rate and 95% confidence intervals (CI) based on inclusion and exclusion criteria. Subgroup analysis was employed to explore heterogeneity. This study is registered in PROSPERO, CRD42021293175.
We identified 5128 records, of which 21 articles that included 34,6571 adults. The pooled coverage rate and 95% confidence intervals were 26.27% and 22.73-29.82%, respectively. The pooled coverage rates were 22.06% (95% CI: 15.35-28.78%), 33.81% (95% CI: 28.77-38.85%) and 23.50% (95% CI: 17.37-29.64%) in eastern China, central China and western China, respectively. Furthermore, males had a pooled hepatitis B vaccination coverage rate of 23.47% (95% CI: 15.61-31.33%), whereas, in females, the coverage rate was 26.60% (95% CI: 18.73-34.47%). The pooled hepatitis B vaccination coverage rate in the age group younger than 40 years was 36.93% (95% CI: 28.35-45.50%), while in the ≥40-year-old group, the pooled hepatitis B vaccination coverage rate was 17.09% (95% CI: 10.18-24.00%). The pooled hepatitis B vaccination coverage rate in urban areas (40.29%, 95% CI: 20.91-59.67%) was higher than in rural areas (16.54%, 95% CI: 7.80-25.29%). The average weighted, pooled hepatitis B vaccination coverage rate was 26.53% (20.25-32.81%) in 2011-2015 and 26.12% (22.04-30.20%) in 2016-2021.
This systematic review provides the hepatitis B vaccination coverage rate of adults in China (26.27%). The low prevalence of vaccine-mediated immunity among adults in China underscores the urgent need for targeted immunization strategies for vulnerable Chinese adults to ensure progress toward the target of eliminating hepatitis B by 2030.
预防乙型肝炎病毒（HBV）感染的最有效方法是接种疫苗。关于中国成年人乙型肝炎疫苗接种覆盖率的综合数据很少。我们旨在估计中国成年人的乙型肝炎疫苗接种率。
我们检索了PubMed、EMBASE、Cochrane图书馆、中国知网、万方和维普数据库，查找2011年1月1日至2021年10月1日发表的观察性研究。使用标准化表格提取数据，根据纳入和排除标准估计合并疫苗接种覆盖率及95%置信区间（CI）。采用亚组分析探讨异质性。本研究已在国际前瞻性系统评价注册库（PROSPERO）注册，注册号为CRD42021293175。
我们共识别出5128条记录，其中21篇文章纳入了346571名成年人。合并接种覆盖率及95%置信区间分别为26.27%和22.73 - 29.82%。中国东部、中部和西部的合并接种覆盖率分别为22.06%（95%CI：15.35 - 28.78%）、33.81%（95%CI：28.77 - 38.85%）和23.50%（95%CI：17.37 - 29.64%）。此外，男性的合并乙型肝炎疫苗接种覆盖率为23.47%（95%CI：15.61 - 31.33%），而女性的覆盖率为26.60%（95%CI：18.73 - 34.47%）。40岁以下年龄组的合并乙型肝炎疫苗接种覆盖率为36.93%（95%CI：28.35 - 45.50%），而40岁及以上组的合并乙型肝炎疫苗接种覆盖率为17.09%（95%CI：10.18 - 24.00%）。城市地区的合并乙型肝炎疫苗接种覆盖率（40.29%，95%CI：20.91 - 59.67%）高于农村地区（16.54%，95%CI：7.80 - 25.29%）。2011 - 2015年的平均加权合并乙型肝炎疫苗接种覆盖率为26.53%（20.25 - 32.81%），2016 - 2021年为26.12%（22.04 - 30.20%）。
本系统评价提供了中国成年人乙型肝炎疫苗接种覆盖率（26.27%）。中国成年人中疫苗介导免疫的低流行率凸显了针对中国脆弱成年人制定针对性免疫策略的迫切需求，以确保在2030年实现消除乙型肝炎目标方面取得进展。
