title: Hepatitis B birth dose vaccination rates among children in Beijing: A comparison of local residents and first and second generation migrants.
abstract: Providing hepatitis B vaccine to all neonates within 24 hours of birth (Timely Birth Dose, TBD) is the key preventative measure to control perinatal hepatitis B virus infection. Previous Chinese studies of TBD only differentiated between migrant and non-migrant (local-born generation-LG) children. Our study is the first to stratify migrants in Beijing into first generation migrants (FGM) and second generation migrants (SGM). Based on a questionnaire survey of 2682 people in 3 Beijing villages, we identified 283 children aged 0-15 years, from 246 households, who were eligible for a TBD. Multinomial logistic regression and statistical analyses were used to examine factors explaining TBD rates for LG, FGM and SGM children. Surprisingly, the TBD for LG Beijing children was not significantly different from migrant children. But after stratifying migrant children into FGM and SGM, revealed significant TBD differences were revealed across LG, FGM and SGM according to domicile (p-value < 0.001, OR = 3.24), first vaccination covered by government policy (p-value < 0.05, OR = 3.24), mother's knowledge of hepatitis B (p-value < 0.05, OR = 1.01) and the government's HBV policy environment (p-value < 0.05, OR = 2.338). Birthplace (p-value = 0.002, OR = 6.21) and better policy environments (p-value = 0.01, OR = 2.80) were associated with higher TBD rate for LG and SGM children. Compared with FGM children, SGM had a significantly poorer TBD rate (Fisher exact test of chi-square = 0.013). We identified SGM as a special risk group; proposed Hukou reform to improve SGM TBD; and called for Beijing health authorities to match TBD rates in other provinces, especially by improving practices by health authorities and knowledge of parents.
authors.affiliation: a Center for Health Economic Experiments and Public Policy, School of Public Health, Shandong University , Jinan , Shandong , China.
authors.forename: Ruohan
authors.initials: R
authors.lastname: Chen
authors.affiliation: b School of Humanity and Social Science, Shandong University of TCM , Jinan , Shandong , China.
authors.forename: Youwei
authors.initials: Y
authors.lastname: Li
authors.affiliation: c Department of Health Management and Health Economics , University of Oslo , Oslo , Norway.
authors.forename: Knut Reidar
authors.initials: KR
authors.lastname: Wangen
authors.affiliation: d School of Management-School of Commerce, Tianjin Normal University, Tianjin, PRC; School of International Business, Beijing Foreign Studies University, Haidian, Beijing, PRC; Research Institute of International Strategies, Guangdong University of Foreign Studies, Guangzhou, PRC; Newcastle Business School, University of Newcastle , Newcastle , NSW , Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Nicholas
authors.affiliation: e UNSW Business School, UNSW , Sydney , NSW , Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Maitland
authors.affiliation: f Center for Health Economic Experiments and Public Policy, School of Public Health, Shandong University , Jinan , Shandong , China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000068476:Beijing / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D054625:Healthcare Disparities; D006509:Hepatitis B / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D010290:Parents / Q000193:education; D018743:Perinatal Care / Q000379:methods; D011247:Pregnancy; D011795:Surveys and Questionnaires; D014171:Transients and Migrants; D014611:Vaccination / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*
chemical_list: D017325:Hepatitis B Vaccines
keywords: first generation migrant; hepatitis B; migrant children; policy inequity; second generation migrant; timely birth dose; vaccination