Factors of post-vaccination serological testing coverage among hepatitis B-exposed children in Fujian, China: a population-based cohort study (2021-2023).

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.