Building the evidence for hepatitis B vaccination programs for students and researchers working with biological samples in Indian Institutes of Higher Education

Figures & data

Figure 1. Participants’ hepatitis B vaccination status and place of origin.

Map of India depicting the baseline hepatitis B vaccination status and the place of origin of all participants.

Table 1. Hepatitis B vaccination status of participants

		Fully vaccinated	Incompletely vaccinated	Vaccinated dose unknown	Not vaccinated	Vaccination status unknown
	Total	n (%)	n (%)	n (%)	n (%)	n (%)
Total	N = 185	49 (26%)	21 (11%)	6 (3%)	84 (45%)	25 (14%)
Year of participation
2018	121	38 (31%)	16 (13%)	3 (2%)	52 (43%)	12 (10%)
2019	64	11 (17%)	5 (8%)	3 (5%)	32 (50%)	13 (20%)
Gender
Male	109	31 (28%)	13 (12%)	3 (3%)	46 (42%)	16 (15%)
Female	76	18 (24%)	8 (11%)	3 (4%)	38 (50%)	9 (12%)
Age (years)	Median (Q1, Q3) = 27 (24, 30)
18–29	137	34 (25%)	15 (11%)	5 (4%)	67 (49%)	16 (12%)
30–49	43	15 (35%)	6 (14%)	1 (2%)	13 (30%)	8 (19%)
50–64	5	0 (0%)	0 (0%)	0 (0%)	4 (80%)	1 (20%)
Department
School of Medical Science & Technology	164	48 (29%)	18 (11%)	3 (2%)	75 (46%)	20 (12%)
Department 2^a	21	1 (5%)	3 (14%)	3 (14%)	9 (43%)	5 (24%)
Designation
Faculty	10	3 (30%)	0 (0%)	0 (0%)	3 (30%)	4 (40%)
PhD student/Postdoctoral fellow	93	17 (18%)	11 (12%)	6 (6%)	39 (42%)	20 (22%)
Medical graduate	27	18 (67%)	6 (22%)	0 (0%)	3 (11%)	0 (0%)
Masters student	39	9 (23%)	2 (5%)	0 (0%)	28 (72%)	0 (0%)
Staff	16	2 (13%)	2 (13%)	0 (0%)	11 (69%)	1 (6%)

^aDepartment 2: a second department involved in research with biological materials.

Table 2. Hepatitis B vaccine clinic participation

	1st round	2nd round
Time period of vaccine clinics	February–September 2019	November 2019–March 2020
Number of vaccine clinics	23	2
Number of participants (N)	77	33
Designation	n (%)	n (%)
PhD student/postdoctoral fellow	42 (55%)	16 (48%)
Medical graduate	1 (1%)	1 (3%)
Masters student	17 (22%)	16 (48%)
Staff	16 (21%)	0 (0%)
Community	1 (1%)	0 (0%)
Department	n (%)	n (%)
School of Medical Science & Technology	70 (91%)	26 (79%)
Department 2^a	0 (0%)	7 (21%)
Other	7 (9%)	0 (0%)
Doses given	n (%)	n (%)
1 dose	7 (9%)	4 (12%)
2 doses	11 (14%)	29 (88%)
3 doses	59 (77%)	0 (0%)
Completed vaccination schedule	70 (91%)	1 (3%)
Total number of doses given	209	62

^aDepartment 2: a second department involved in research with biological materials.

Table 3. Determinants of hepatitis B vaccine uptake (N = 64)

The 5As	Definition	Questions	Very important	Important	Neutral	Less important	Not important
Access	Access is the ability of a person to reach or to be reached by a vaccine.	1. How important was getting the vaccine in institute?	49 (77%)	12 (19%)	3 (5%)	0 (0%)	0 (0%)
		2. How important was having options of multiple days for getting the vaccine?	45 (70%)	15 (23%)	4 (6%)	0 (0%)	0 (0%)
		3. How important was getting vaccine in evening hours?	16 (25%)	29 (45%)	18 (28%)	1 (2%)	0 (0%)
Affordability	Affordability is the ability to afford the vaccine due to financial and nonfinancial costs	4. How important was getting vaccine during working hours?	12 (19%)	11 (17%)	27 (42%)	7 (11%)	7 (11%)
		5. How important was having the vaccine available for free?	50 (78%)	11 (17%)	2 (3%)	1 (2%)	0 (0%)
Acceptance	Acceptance is the degree to which individuals accept, refuse, or question vaccines.	6. How important was getting the vaccine with others in the department?	31 (48%)	19 (30%)	11 (17%)	0 (0%)	3 (5%)
		7. How important was the recommendation of the doctor in your decision to get the Hepatitis B vaccine?	45 (70%)	14 (22%)	3 (5%)	1 (2%)	1 (2%)
Activation	Activation describes the nudge toward vaccine uptake.	8. How important was it to get phone call reminders to schedule vaccine appointments?	40 (63%)	16 (25%)	7 (11%)	1 (2%)	0 (0%)
		9. How important was it to get e-mail reminders to schedule vaccine appointment?	37 (58%)	19 (30%)	8 (13%)	0 (0%)	0 (0%)
		10. How important was it to have a personal face-to-face reminder to schedule vaccine appointment?	24 (38%)	21 (33%)	12 (19%)	5 (8%)	2 (3%)
		11. How important was the poster in SMST on hepatitis B immunization in getting the vaccine?	24 (38%)	21 (33%)	16 (25%)	1 (2%)	2 (3%)
		12. How important was the Government of India’s requirement to take hepatitis B vaccine for occupationally exposed employees in your decision?	44 (69%)	7 (11%)	9 (14%)	3 (5%)	1 (2%)

Table 4. Hepatitis B awareness among study participants (N = 85)

The 5As and definition	Statements	Strongly agree	Agree	Neutral	Disagree	Strongly disagree
Awareness: Awareness is the degree of an individuals’ knowledge about vaccines and their objective benefits and risks.	1. Hepatitis B is the leading cause of hepatocellular carcinoma.	23 (27%)	34 (40%)	23 (27%)	3 (4%)	2 (2%)
	2. Hepatitis B can be caught by touching a contaminated surface.	18 (21%)	24 (28%)	25 (29%)	11 (13%)	7 (8%)
	3. Hepatitis B can be transmitted through human cell culture.	22 (26%)	31 (36%)	26 (31%)	5 (6%)	1 (1%)
	4. Hepatitis B can be caught by handling bio-waste.	30 (35%)	36 (42%)	17 (20%)	1 (1%)	1 (1%)
	5. Hepatitis B vaccine is effective in preventing Hepatitis B.	40 (47%)	40 (47%)	5 (6%)	0 (0%)	0 (0%)
	6. Hepatitis B vaccine is safe.	34 (40%)	38 (45%)	13 (15%)	0 (0%)	0 (0%)
	7. Vaccines are a major advancement of humanity.	53 (62%)	29 (34%)	3 (4%)	0 (0%)	0 (0%)
	8. I am afraid of injections.	11 (13%)	11 (13%)	14 (16%)	24 (28%)	25 (29%)
	9. To protect public health, we should follow government guidelines about vaccines.	50 (59%)	30 (35%)	5 (6%)	0 (0%)	0 (0%)
	10. By vaccinating myself, I protect myself and others.	51 (60%)	28 (33%)	5 (6%)	1 (1%)	0 (0%)
	11. I do not think vaccines are important in my life.	3 (4%)	2 (2%)	4 (5%)	21 (25%)	55 (65%)

Figure 2. Framework for understanding hepatitis B vaccine uptake using the social ecological model.

Social Ecological Model of HBV vaccine uptake by individual, departmental, institutional, and national factors.