Improved timely birth dose coverage of hepatitis B vaccine narrows the socio-economic inequality in western China in 2011–2016

Abstract

ObjectiveTo compare timely birth dose (TBD) coverage of hepatitis B vaccine and socio-economic inequality distribution of TBD coverage between 2011 and 2016 in rural areas of western China. MethodsIn western China, using multi-stage probability proportion to size sampling, 2633 and 1929 children aged 0–35 months with an immunization card were selected from 14 rural counties in 2011 and 2016, respectively. Socio-economic characteristics were obtained from face-to-face questionnaire survey and copies of vaccination certificates. We performed multivariate logistic regression models to identify the determinants of TBD coverage of hepatitis B vaccine. We grouped TBD coverage by wealth quintiles, calculated inequality using the difference base on coverage in richest (quintile 5) and poorest (quintile 1) household wealth quintiles. FindingsFrom 2011 to 2016, the overall TBD coverage of hepatitis B vaccine among children aged 0–35 months in rural areas of western China increased from 52.8% (95% confidence interval, CI: 42.4–62.8) to 80.2% (95% CI: 69.5–87.8). The absolute difference in TBD coverage between richest and poorest quintiles was 20.6 (95%CI: 9.4–31.8) and 15.8 (95%CI: 1.4–30.2) in 2011 and 2016, respectively. ConclusionThe socioeconomic inequality in TBD coverage decreased over the study period, but such inequality still existed in 2016. To improve inequality in TBD, the government should pay more attention to the disadvantaged groups, especially the children who were delivered at home, or whose caregivers were ethnic minority or who have a lower level of education.