Hepatitis E vaccine in China: Public health professional perspectives on vaccine promotion and strategies for control.

Background: A hepatitis E (HepE) vaccine was developed and released in China in 2011. Uptake is currently very limited. The aims of this study were to characterize what public health professionals thought about promoting the HepE vaccine in Shanghai, China, and to develop realistic goals for the HepE vaccine based on this information.

Methods: Public health professionals from Shanghai and other jurisdictions of China were contacted to participate in in-depth qualitative interviews between October 2017 and August 2018. Participants were asked about their perception of the HepE vaccine roll-out. Codes were initially based on the structure of the questionnaire. Subsequently, similar ideas were further developed into themes based on what was present in the transcript data.

Results: Thirty-five individuals participated. Major topics of discussion included (1) clarifying the roles and responsibilities of private and public institutions in promoting and marketing the HepE vaccine, (2) identifying what methods of promotion were most efficient, and, (3) endeavoring to formulate a reasonable and realistic goal, if any, for HepE prevention and control in China. Participants emphasized that public sector sources can be trusted sources of information (although the private vaccination company can also be useful in disseminating information) and social media such as WeChat can be good ways to disseminate articles (although netizens may be worried about the spread of fake news). Vaccine promotion is restrained given limited levels of knowledge in the government, hospitals, and public health vaccination centers.

Conclusion: Successful promotion and use of this vaccine in China, even in limited settings (for instance, certain workplaces, or certain groups) could provide additional information on long-term safety and could promote its adoption in other regions of the world where HepE has high morbidity among pregnant women and other populations.