kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2014.14.3.103 kjhp-14-103 Original Article Hepatitis A Virus Vaccination Status and Related Factors among College Students BaekJae Seong 1 2 HanMi Ah 3 ParkJong 3 YunNa-Ra 4 Department of Public Health, Graduate School of Health Science, Chosun University, Gwangju, Korea Department of Management Planning, Gochang General Hospital, Gochang, Korea Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Korea Department of Internal Medicine, Chosun University Hospital, Chosun University College of Medicine, Gwangju, Korea 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 01 2014 20 01 2014 14 3 103 111 04042014 18082014 Copyright © 2014 The Korean Society of Health Promotion and Disease Prevention 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.

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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 levela
 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 recordb  
 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 usea  
 None 40 (8.0)
 <1/month 121 (24.1)
 ≥1/month 342 (68.0)
Smoking statusa  
 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)

Percentages may not add to 100 due to rounding.

Excluded one case with missing value.

HAV awareness and vaccination statusa

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, yb 17.8±5.2
 ≤9 10 to 19 ≥20 5 (8.1) 19 (30.7) 38 (61.3)
Second vaccination age, yb 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, monb  
 <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 vaccinationb 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 vaccinationsb
 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 uptakeb 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 vaccinationb Yes No 314 (71.9)123 (28.2)

Abbreviation: HAV, hepatitis A virus.

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

Percentages may not add to 100 due to rounding.

Proportion of vaccination and intention by subject's characteristics

  Vaccination (n=503) Intention (n=437)
N (%) Pa N (%) Pa
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.

Calculated by chi-square test.

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.