What does this research mean for the field?

64.9% of vaccinated adults in Malaysia are susceptible to hepatitis B infection, with higher susceptibility observed among young adults, certain ethnic groups, and individuals with higher education levels. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

What question did this study set out to answer?

This study investigates the prevalence and contributing factors for hepatitis B susceptibility in vaccinated adults in Malaysia.

March 6, 2026Scientific Reports0 citationsOpen Access

Prevalence and factors associated with characteristics of hepatitis B susceptibility among vaccinated adults in Malaysia: a cross-sectional study

FAFilza Noor AsariMinistry of Health EMEida Nurhadzira MuhammadNational Institutes of Biotechnology Malaysia NRNurfatehar RamlyNational Institutes of Biotechnology Malaysia

Key Points

This study investigates the prevalence and contributing factors for hepatitis B susceptibility in vaccinated adults in Malaysia.
Cross-sectional analysis using data from the National Health and Morbidity Survey 2020
Involvement of 4,083 adults aged 15 years and older
Serological testing for hepatitis B virus markers
Complex sampling logistic regression to identify risk factors
64.9% of participants were found to be susceptible to HBV infection
22.9% prevalence of susceptibility among those vaccinated
Higher susceptibility observed in individuals aged 15-29 (19.0%)
Significant associations with ethnicity, particularly higher odds in Chinese and other ethnic groups
Education level greatly influenced susceptibility, with higher odds in individuals with tertiary and secondary education

Abstract

Hepatitis B vaccination is a cornerstone of global disease prevention, yet susceptibility among vaccinated individuals remains a concern. This study aimed to determine the prevalence and factors associated with hepatitis B susceptibility in vaccinated adults in Malaysia. A cross-sectional analysis was conducted using data from the National Health and Morbidity Survey (NHMS) 2020, involving 4,083 respondents aged 15 years and older. Serological testing for hepatitis B virus (HBV) markers, HBsAg, anti-HBs, and anti-HBc assays was performed. Susceptibility was defined based on serological profiles, and complex sampling logistic regression was employed to identify associated risk factors. Among the participants, 64.9% (2,649/4,083) were susceptible to HBV infection, with a prevalence of 22.9% among vaccinated individuals. Susceptibility was notably higher in young adults aged 15–29 (19.0%), and Malay ethnic group (20.5%). Additionally, individuals with tertiary education (18.9%) and single marital status (20.1%) exhibited elevated susceptibility. Multivariate analysis revealed significant associations with ethnicity, where Chinese (aOR 7.10, 95% CI: 2.67, 18.91) and other ethnic groups (aOR 5.67, 95% CI: 2.03, 15.92) had higher odds of susceptibility compared to Malays. Education level was another strong predictor, with tertiary (aOR 9.82, 95% CI: 3.61, 26.73), secondary (aOR 8.88, 95% CI: 3.42, 23.11), and primary education (aOR 6.96, 95% CI: 2.77, 17.51) showing substantially increased odds relative to no formal education. This study highlights a substantial prevalence of hepatitis B susceptibility among vaccinated adults in Malaysia. Ethnicity and education level emerged as significant factors. These findings underscore the need for targeted interventions, such as booster vaccinations or enhanced screening, particularly for high-risk groups like the Chinese and other minority ethnicities, as well as those with higher education levels. Further research is warranted to explore these associations’ underlying reasons and optimize vaccination strategies in Malaysia.

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