Coverage of Haemophilus influenzae Type b Conjugate Vaccine for Children in Mainland China: Systematic Review and Meta-Analysis.

BACKGROUND: Use of Haemophilus influenzae type b conjugate vaccine is effective in reducing the disease burden but its coverage in China is unclear. The aim of this meta-analysis is to assess the coverage of Hib conjugate vaccines in children in Mainland China.

METHODS: We systematically searched Pubmed, Web of Science, Medline, CNKI and Wanfang to identify studies assessing the the coverage of Hib vaccine in Chinese children. Random-effects models were used to obtain pooled estimates for Hib vaccine coverage and analyzed heterogeneity with meta-regression and subgroup analyses.

RESULTS: Thirty-three studies that included 7,227,480 subjects in 12 provinces met our inclusion criteria. The pooled overall coverage of Hib conjugate vaccine was 54.9% (95% CI: 52.9-57.0). The pooled coverage for the non-local population (54.3%, 95%CI 52.4-56.3) was lower than that for the local residents (62.0%, 95% CI 58.4-65.6). The region-pooled coverage was higher in the east of China (59.7%, 95% CI: 57.3-62.1) than the central and west parts of the country (48.5%, 95% CI: 40.6-56.4). Overall, 26.7% (95% CI: 20.1-33.2) had 1 dose only, 14.8% (95%CI: 10.0-19.6%) had 2 doses, 13.5% (95% CI: 9.1-17.8) had 3 doses and 14.3% (95% CI: 9.7-18.9) had 4 doses.

CONCLUSIONS: We found a low coverage of Hib conjugate vaccine, particularly for the non-local children and those living in the central and west parts of China. Including Hib vaccine into the national immunization program is recommended to reduce disparities in vaccination coverage.