Insights into hepatitis B vaccination decision-making: Exploring vaccine preferences, health disparities, and practice patterns among patients and healthcare providers

Hepatitis B virus (HBV) remains a public health burden, with non-Hispanic Asian/Pacific Islander and non-Hispanic Black persons disproportionately impacted. Social determinants of health influence vaccination rates and healthcare access. This study used HBV vaccination to identify potential drivers of health disparities associated with multidose HBV vaccines, understand how patients and healthcare providers (HCPs) approach HBV vaccine decision-making and selection, and evaluate the patient and HCP preferences for multidose HBV vaccines. Patients (<i>n</i> = 805) and HCPs (<i>n</i> = 300) were recruited through an online survey. Social vulnerability index was used to identify health disparities linked to demographics and socioeconomic status. Results revealed challenges to vaccination, including lengthy appointment durations (40% spending more than 2 hours), high visit costs (27% paying over $100), and appointment cancellations due to affordability concerns (31%). 38% of patients with higher SVI missed an appointment due to cost. Logistic regression analysis for patients' likelihood for vaccine dose decisions did not show significance, despite reported preference for a two-dose HBV vaccine. A multinomial logistic regression showed that when HCPs were aware of a two-dose HBV vaccine, they had 78.5% lower odds of recommending a three-dose HBV vaccine (OR = 0.215, 95 CI [0.101, 0.458], <i>p</i> < .001). 97% of HCPs agreed that their responsibilities include discussing vaccination with patients, but only 33% did so. There is an opportunity to improve low HBV vaccination rates through HCP influence. This study exposed barriers that patients face in accessing preventive healthcare. The two-dose HBV vaccine may address healthcare disparities and, by reducing appointment burden, could assist socially vulnerable individuals.