STUDY PROTOCOL article
Front. Pediatr.
Sec. Pediatric Infectious Diseases
Volume 13 - 2025 | doi: 10.3389/fped.2025.1632476
Hepatitis B vaccination coverage rates among Children under five years in India: A systematic review and meta-analysis protocol
Provisionally accepted
K Divyasree Bhat1,2
Abhinav Sinha2
Haimanti Bhattacharya2
J Yuvaraj3
Sanghamitra Pati2*
Debdutta Bhattacharya2*- 1Tamil Nadu Dr. M.G.R. Medical University, Chennai, India
- 2Regional Medical Research Center (ICMR), Bhubaneswar, India
- 3National Institute of Epidemiology (ICMR), Chennai, India
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Hepatitis B virus (HBV) affects an estimated 1.5 million people globally each year, with nearly 296 million living with chronic infection, contributing significantly to cirrhosis, liver cancer, and premature mortality. Despite the availability of a highly effective vaccine, Hepatitis B remains endemic in many low-and middle-income countries, including India, due to barriers in healthcare access and low vaccination uptake. While a timely birth dose prevents perinatal transmission, completion of the full vaccine schedule is essential to prevent horizontal transmission-a major mode of infection in India. India introduced the hepatitis B vaccine in select districts in 2002-2003 and scaled it nationally through the Universal Immunization Programme in 2011-2012.This systematic review and meta-analysis aims to estimate the pooled coverage of hepatitis B vaccination among children under five years of age across different regions of India.A comprehensive literature search will be conducted using PubMed, Embase, and CINAHL databases for studies published between January 1, 2000, and May 30, 2024. Search terms will include "Hepatitis B," "vaccination coverage," "children," and "India," combined using Boolean operators. Two independent reviewers will screen titles, abstracts, and full texts for eligibility. The AXIS tool will be used to assess the quality of cross-sectional studies. Pooled coverage rates will be estimated using a random-effects meta-analysis model. Heterogeneity will be assessed using the I² statistic and Cochran's Q test. Publication bias will be evaluated through funnel plots and Egger's test. Sensitivity and subgroup analyses will be conducted to explore the robustness of results and sources of heterogeneity.As this review will analyse previously published data, ethical approval is not required. Findings will be disseminated through a peer-reviewed journal and scientific conferences.
Keywords: Hepatitis B, Vaccine coverage, Under-five children, India, Systematic review, Meta-analysis
Received: 21 May 2025; Accepted: 13 Aug 2025.
Copyright: © 2025 Divyasree Bhat, Sinha, Bhattacharya, Yuvaraj, Pati and Bhattacharya. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Sanghamitra Pati, Regional Medical Research Center (ICMR), Bhubaneswar, India
Debdutta Bhattacharya, Regional Medical Research Center (ICMR), Bhubaneswar, India
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.