Background: 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.
Methods: 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.
Results: 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.
Conclusions: 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.
Keywords: China; adult; hepatitis B virus; meta-analysis; vaccination.