Peer-reviewed article
Factors of post-vaccination serological testing coverage among hepatitis B-exposed children in Fujian, China: a population-based cohort study (2021-2023).
Xinxin Huang, Yongfan Chen, GuiHua Liu, Chengyu Huang, Xiaomeng Xue et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined post-vaccination serological testing (PVST) coverage among children exposed to hepatitis B in Fujian Province, China between 2021 and 2023. PVST coverage improved significantly from 32.4% in 2021 to 79.2% in 2023, with higher coverage among high-risk children. The study identified several factors associated with incomplete PVST, including maternal age, education level, employment status, and antiviral medication use. Mother-to-child transmission failure rates declined from 0.8% to 0.3% during this period.
Key points
- PVST coverage increased from 32.4% (2021) to 79.2% (2023), with higher rates among high-risk children (70.5%) than common exposure children (53.2%)
- Mother-to-child transmission failure rates dropped from 0.8% to 0.3%
- Over half of children received PVST more than 2 months after immunization, exceeding the recommended 1-2 month window
- Maternal age ≥30 years, education ≤ high school, and parity ≥2 times were factors associated with non-completion of PVST
- Maternal employment as laborer or farmer was protective against non-completion for common exposure children (OR=0.833)
Limitations
The study is observational and cannot establish causation for the identified factors. The analysis focuses on coverage and timing of PVST rather than evaluating the direct effectiveness of PVST in preventing HBV transmission or clinical outcomes in vaccinated children.
Abstract
BACKGROUND: Mother-to-child transmission (MTCT) of the hepatitis B virus (HBV) is still a major public health concern worldwide, especially in high-burden nations like China. In order to assess the effectiveness of children vaccinations and stop MTCT, post-vaccination serological testing (PVST) is crucial. However, there are obstacles to PVST implementation. OBJECTIVE: The purpose of study is to evaluate the existing local strategies for preventing MTCT and suggest possible improvements by analyzing the dynamics of PVST coverage in children exposed to HBV and the factors that influence it in Fujian Province between 2021 and 2023. METHODS: Data from the China Immunization Planning Information System and the China Information System for Prevention of Mother-to-Child Transmission was used in the population-based cohort research. To describe the current status of PVST implementation and find factors linked to it, multivariable logistic regression were used, stratified by high-risk (maternal HBV DNA ≥2 × 105 IU/ml or HBeAg-positive) and common HBV-exposed children. RESULTS: From 32.4% in 2021 to 79.2% in 2023, PVST coverage rose dramatically, with higher rates among high-risk children (70.5%) than among children with common exposure (53.2%). Failure rates for MTCT dropped from 0.8 to 0.3%. However, the recommended 1-2-month range was exceeded, with over half of children undergoing PVST more than 2 months following immunization. For children with high exposure to HBV, antiviral medication use (OR = 1.575, 95% CI = 1.452-1.708, P < 0.01) and pregnancy duration ≥37 weeks (OR = 1.433, 95% CI = 1.198-1.708, P < 0.01) were revealed to be risk factors for not completing PVST. For children with common exposure to HBV, one factor for not completing PVST was the mother's employment as a labor or farmer (OR = 0.833, 95% CI = 0.780-0.889, P < 0.01). For all children exposed to HBV, maternal age ≥30 years, education ≤ high school, and maternal parity ≥2 times were important factors for non-completion. CONCLUSIONS: In terms of PVST coverage and MTCT control, Fujian Province made impressive strides. Maintaining the progress toward MTCT elimination requires the antepartum and postpartum observation periods incorporate a consistent instructional procedure.