Hepatitis B infection status & vaccine coverage among under five children in Mayurbhanj district, Eastern India

Background & objectives Hepatitis B virus (HBV) infection continues to pose a major public health challenge, especially among rural and tribal communities where access to healthcare services is often limited. The present study aimed to assess the status of HBV infection among children between 1 to 5 yr of age and to evaluate vaccination coverage in the Mayurbhanj district of Odisha. Methods A cross-sectional study was conducted among children aged 1-5 yr. Blood samples were tested for Hepatitis B surface antigen (HBsAg), antibody to Hepatitis B surface antigen (anti-HBs) and other serological markers to determine infection status and vaccination coverage. Results HBsAg seropositivity, indicating active HBV infection, was detected in 0.6 per cent [95% confidence interval (CI): 0.3-0.9] of the samples. Similarly, anti-HBc was tested positive in 0.4 per cent (95% CI: 0.2-0.8) of children. The combined prevalence of HBV infection-based on positivity for either HBsAg or anti-HBc-was 0.8 per cent (95% CI: 0.5-1.2). Vaccination data were collected for 2,647 (98.0%) children of which 90.9 per cent received the birth dose of Hepatitis B vaccine. A total of 98.1 per cent received pentavalent 1 (Penta 1), whereas 97.3 per cent and 96.1 per cent of children received Penta 2 and Penta 3. However, 72.6 per cent (1,961) had protective levels of antibody (anti-HBs) above the threshold, signifying adequate immune protection and 27.4 per cent had sub-protective anti-HBs levels (<10 IU/mL), indicating insufficient immunity. Interpretation & conclusions The results of this study highlighted the need for targeted interventions-such as improving timely administration of the birth dose, enhancing follow-up for subsequent doses including digital or paper-based tools, implementing a robust tracking and reminder system to ensure HBV vaccination series and increasing awareness through community-based health education-to strengthen acceptance of HBV vaccination in rural and tribal communities.