Machmud Putri Bungsu, Führer Amand, Gottschick Cornelia, Mikolajczyk Rafael
Institute of Medical Epidemiology, Biometrics, and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany.
Department of Epidemiology, Public Health Faculty, Universitas Indonesia, Jl. Prof Dr Bahder Djohan, Depok 16424, Jawa Barat, Indonesia.
Vaccines (Basel). 2023 Feb 9;11(2):398. doi: 10.3390/vaccines11020398.
To reach the goals of the Global Hepatitis Elimination 2030 program, Indonesia is now preparing a new regulation for hepatitis B vaccinations for adult population. This study aimed to determine the factors influencing vaccine uptake for hepatitis B in the adult population, and identify barriers to, and facilitators of, hepatitis B vaccination programmes. An explanatory sequential mixed methods design was implemented in this study. We conducted a survey involving 893 participants in the general population followed by 14 in-depth interviews with health providers. The survey found that only 15% (95% confidence interval 13-18%) of participants received at least one dose of the hepatitis B vaccine. Factors associated with vaccine uptake were, living in Yogyakarta compared to living in Aceh, having secondary and higher education compared to primary education, working as a health worker compared to working in other sectors, and having health insurance that covered hepatitis B vaccination compared to not having such health insurance. Our qualitative study also identified several barriers to the adult hepatitis B vaccination programme in Indonesia such as the high cost of vaccination, lack of vaccine availability in certain areas, limited human resources to implement the hepatitis B vaccination programme, and the ineffective dissemination of hepatitis B vaccination. This study highlights that accessibility and affordability of vaccinations are important determinants of vaccination uptake that should be taken into account when planning vaccination campaigns.
为实现“2030年全球消除肝炎”计划的目标，印度尼西亚目前正在制定一项针对成年人群的乙肝疫苗接种新规定。本研究旨在确定影响成年人群乙肝疫苗接种率的因素，并找出乙肝疫苗接种计划的障碍和促进因素。本研究采用了解释性序列混合方法设计。我们对893名普通人群参与者进行了调查，随后对医疗服务提供者进行了14次深入访谈。调查发现，只有15%（95%置信区间13 - 18%）的参与者接种了至少一剂乙肝疫苗。与疫苗接种率相关的因素包括，与居住在亚齐相比，居住在日惹；与小学教育程度相比，具有中学及以上教育程度；与在其他部门工作相比，从事卫生工作；与没有涵盖乙肝疫苗接种的医疗保险相比，拥有涵盖乙肝疫苗接种的医疗保险。我们的定性研究还确定了印度尼西亚成人乙肝疫苗接种计划的几个障碍，如疫苗接种成本高、某些地区疫苗供应不足、实施乙肝疫苗接种计划的人力资源有限以及乙肝疫苗接种宣传不力。本研究强调，疫苗的可及性和可负担性是疫苗接种率的重要决定因素，在规划疫苗接种运动时应予以考虑。
