Hepatitis A Virus Vaccination Status and Related Factors among College Students

Jae Seong Baek; Mi Ah Han; Jong Park; Na-Ra Yun

doi:10.15384/kjhp.2014.14.3.103

Korean J Health Promot > Volume 14(3); 2014 > Article

Baek, Han, Park, and Yun: Hepatitis A Virus Vaccination Status and Related Factors among College Students

Original Article

Korean Journal of Health Promotion 2014;14(3):103-111.

Published online: January 20, 2014

DOI: https://doi.org/10.15384/kjhp.2014.14.3.103

Hepatitis A Virus Vaccination Status and Related Factors among College Students

¹Department of Public Health, Graduate School of Health Science, Chosun University, Gwangju, Korea

²Department of Management Planning, Gochang General Hospital, Gochang, Korea

³Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Korea

⁴Department of Internal Medicine, Chosun University Hospital, Chosun University College of Medicine, Gwangju, Korea

Jae Seong Baek^1,², Mi Ah Han^3,, Jong Park³, Na-Ra Yun⁴

Corresponding author：Mi Ah Han, MD, PhD Department of Preventive Medicine, College of Medicine, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju 501-759, Korea
Tel: +82-62-230-6481, Fax: +82-62-225-8293 E-mail: mahan@chosun.ac.kr

Received April 04, 2014 Accepted August 18, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Hepatitis A is an acute infectious disease of the liver caused by the hepatitis A virus (HAV). The purpose of this study was to investigate the HAV vaccination status and related factors among college students.

Methods

The study subjects were 503 students conveniently sampled from C university located in one district of Jeollanamdo. General characteristics and HAV vaccination related factors were collected by a self-reported questionnaire in October 2013. Chi-square tests and multiple logistic regression analyses were used to evaluate related factors with HAV vaccination.

Results

Of the 503 subjects without a history of HAV infection, 65 subjects (12.9%) reported that they were vaccinated. In multiple analyses, subjects who have had health screening (adjusted odds ratio, aOR=2.44 and 95% confidence interval, 95% CI=1.26–4.73) and those who were aware of HAV infection (aOR=6.00, 95% CI=1.81–19.91) or who perceived the benefits of HAV vaccine (aOR=2.05, 95% CI=1.07–3.93) were more likely to be vaccinated than those not involved in these factors. With regard to intention for HAV vaccine, 314 subjects (71.9%) reported that they have the intention to be vaccinated against HAV. In multiple analyses, higher grade level, high monthly allowance, awareness of HAV vaccine, perceived susceptibility of HAV, perceived seriousness of HAV and perceived benefits of HAV vaccine were significantly associated with the intention for HAV vaccination.

Conclusions

The vaccination rate for HAV was found to be low in our sample of college students. To reduce health risks related with HAV, prevention efforts should consider these results.

Keywords: Hepatitis A, Risk factors, Vaccination

Table 1.

General characteristics of study participants

Characteristics	N (%)
Sex
Male	252 (50.1)
Female	251 (49.9)
Major
Health care related group	245 (48.7)
Non-health care related group	258 (51.3)
Grade level^a
1	204 (40.6)
2	103 (20.5)
3	123 (24.5)
4	73 (14.5)
Monthly allowance, Korean Won
≤200,000	178 (35.4)
210,000 to 300,000	183 (36.4)
≥310,000	142 (28.2)
School record^b
High	136 (27.1)
Middle	265 (52.8)
Low	101 (20.1)
Father's education level
≤Middle school	67 (13.3)
High school	271 (53.9)
≤College	165 (32.8)
Mother's education level
≤Middle school	68 (13.5)
High school	306 (60.8)
≤College	129 (25.7)
Frequency of alcohol use^a
None	40 (8.0)
<1/month	121 (24.1)
≥1/month	342 (68.0)
Smoking status^a
Never smoker	353 (70.2)
Ex-smoker	30 (6.0)
Current smoker	120 (23.9)
Family history of liver disease
No	443 (88.1)
Yes	60 (11.9)
Health screening
Yes	319 (63.4)
No	184 (36.6)
Private insurance
Yes	445 (88.5)
No	58 (11.5)

^aPercentages may not add to 100 due to rounding.

^bExcluded one case with missing value.

Table 2.

HAV awareness and vaccination status^a

HAV awareness among all subjects	N=503
[Awareness] Have you heard about HAV infection?^b Yes No	381 (75.8) 122 (24.3)
[Awareness] Have you heard about HAV vaccine? Yes No	354 (70.4) 149 (29.6)
[Perceived susceptibility] Do you think you can be easily infected with HAV? Yes No	355 (70.6) 148 (29.4)
[Perceived seriousness] Do you think HAV infection is a serious disease? Yes No	250 (49.7) 253 (50.3)
[Perceived benefits] Do you think HAV infection is preventable after HAV vaccination? Yes No	336 (66.8) 167 (33.2)
HAV vaccination Yes No Do not know	65 (12.9) 207 (41.2) 231 (45.9)
Characteristics related to HAV vaccination	N=65
First vaccination age, y^b	17.8±5.2
≤9 10 to 19 ≥20	5 (8.1) 19 (30.7) 38 (61.3)
Second vaccination age, y^b	18.1±5.3
≤9 10 to 19 ≥20	4 (8.2) 14 (28.6) 31 (63.3)
Time interval between 1st and 2nd vaccination, mon^b
<6 6 to 12 ≥13	12 (19.4) 32 (51.6) 5 (8.1)
Did not receive second vaccination Place of vaccination	13 (21.0)
Community health center Local hospital/clinic General hospital Others	14 (22.6) 37 (59.7) 5 (8.1) 6 (9.7)
Reason for vaccination^b Self-decision Family opinion Health professional recommendation Others	19 (30.7) 27 (43.6) 8 (12.9) 8 (12.9)
Characteristics of HAV unvaccinated subjects	N=437
Perceived reason for not having HAV vaccinations^b
Didn't know about vaccine No need for vaccine No time High cost Afraid of injection Unconvinced about efficacy of vaccine Afraid of side-effects Others	152 (34.8) 98 (22.4) 61 (14.0) 39 (8.9) 27 (6.2) 7 (1.6) 6 (1.4) 47 (10.8)
Perceived facilitators to future HAV vaccine uptake^b Health professional recommendation Useful information about vaccination Reduction of vaccination cost Plenty of time Other vaccination methods such as oral pills except injection Single shot vaccine without second dose Others	118 (27.1) 85 (19.5) 85 (19.5) 52 (11.9) 46 (10.6) 34 (7.8) 16 (3.7)
Intention for HAV vaccination^b Yes No	314 (71.9) 123 (28.2)

Abbreviation: HAV, hepatitis A virus.

^aValues are presented as N (%) or mean±SD.

^bPercentages may not add to 100 due to rounding.

Table 3.

Proportion of vaccination and intention by subject's characteristics

	Vaccination (n=503)		Intention (n=437)
	N (%)	P^a	N (%)	P^a
Sex		0.005		0.009
Male Female	22 (8.7) 43 (17.1)		153 (66.5) 161 (77.8)
Major		0.001		0.119
Health care related group Non-health care related group	44 (18.0) 21 (8.1)		151 (75.5) 163 (68.8)
Grade level		0.070		0.001
1 2 3 4	19 (9.3) 11 (10.7) 22 (17.9) 13 (17.8)		120 (64.9) 62 (67.4) 79 (79.0) 53 (88.3)
Monthly allowance, Korean Won		0.149		0.006
≤200,000 210,000 to 300,000 ≥310,000	16 (9.0) 28 (15.3) 21 (14.8)		107 (66.1) 125 (81.2) 82 (67.8)
School record		0.950		0.972
High Middle Low	17 (12.5) 34 (12.8) 14 (13.9)		86 (72.3) 164 (71.3) 63 (72.4)
Father's education level		0.325		0.967
≤Middle school High school ≥College	6 (9.0) 33 (12.2) 26 (15.8)		43 (70.5) 171 (72.2) 100 (71.9)
Mother's education level		0.206		0.125
≤Middle school High school ≥College	6 (8.8) 37 (12.1) 22 (17.1)		39 (62.9) 201 (75.0) 74 (69.2)
Frequency of alcohol use		0.196		0.986
None <1/month ≥1/month	6 (15.0) 21 (17.4) 38 (11.1)		24 (70.6) 72 (72.0) 218 (72.0)
Smoking status		0.547		0.912
Never smoker Ex-smoker Current smoker	48 (13.6) 2 (6.7) 15 (12.5)		217 (71.4) 21 (75.0) 76 (72.4)
Family history of liver disease		0.082		0.393
No Yes	53 (12.0) 12 (20.0)		277 (71.2) 37 (77.1)
Health screening		0.007		0.119
Yes No	51 (16.0) 14 (7.6)		199 (74.5) 115 (67.7)
Private insurance		0.834		0.048
Yes No	57 (12.8) 8 (13.8)		284 (73.4) 30 (60.0)
Awareness of HAV infection		<0.001		<0.001
Yes No	62 (16.3) 3 (2.5)		246 (77.4) 68 (57.1)
Awareness of HAV vaccine		<0.001		<0.001
Yes No	64 (18.1) 1 (0.7)		230 (79.6) 84 (56.8)
Perceived susceptibility of HAV		0.362		<0.001
Yes No	49 (13.8) 16 (10.8)		238 (78.0) 76 (57.6)
Perceived seriousness of HAV		0.130		<0.001
Yes No	38 (15.2) 27 (10.7)		171 (80.7) 143 (63.6)
Perceived benefits of HAV vaccine		0.032		0.067
Yes No	51 (15.2) 14 (8.4)		213 (74.7) 101 (66.5)

Abbreviation: HAV, hepatitis A virus.

^aCalculated by chi-square test.

Table 4.

Adjusted odds ratios for HAV vaccination and intentions

	Vaccination (n=503)	Intention (n=437)
	aOR (95% CI)	aOR (95% CI)
Sex (ref.: male)
Female	1.24 (0.63–2.44)	1.29 (0.80–2.09)
Major (ref.: non-health care related group)
Health care related group	1.80 (0.91–3.56)	–
Grade level (/1)
2	0.88 (0.39–2.02)	0.97 (0.55–1.74)
3	1.98 (0.97–4.07)	2.38 (1.27–4.48)
4	1.36 (0.59–3.15)	3.10 (1.25–7.69)
Monthly allowance (ref.: =200,000 Korean Won)
210,000 to 300,000	–	1.84 (1.04–3.25)
≥310,000	–	0.95 (0.54–1.66)
Family history of liver disease (ref.: no)
Yes	1.57 (0.76–3.27)	–
Health screening (ref.: no)
Yes	2.44 (1.26–4.73)	–
Private insurance (ref.: no)
Yes	–	2.09 (1.05–4.18)
Awareness of HAV infection (ref.: no)
Yes	6.00 (1.81–19.91)	1.24 (0.65–2.38)
Awareness of HAV vaccine (ref.: no)
Yes	–	1.99 (1.07–3.70)
Perceived susceptibility of HAV (ref.: no)
Yes	–	1.83 (1.11–3.01)
Perceived seriousness of HAV (ref.: no)
Yes	–	2.01 (1.23–3.29)
Perceived benefits of HAV vaccine (ref.: no)
Yes	2.05 (1.07–3.93)	1.69 (1.04–2.74)

Abbreviations: HAV, hepatitis A virus; aOR, adjusted odds ratios; CI, confidence interval; ref., reference.

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