High level of exposure to hepatitis B virus infection in a vulnerable population of a low endemic area: A challenge for vaccination coverage

•Hard-to-reach populations remain, with a high exposure of HBV infection.•63.7% of the participants were considered susceptible to HBV infection.•High risk of HBV infection due to living conditions and lack of information.•Low education level may neglect the importance of vaccines.•Accessible language can reduce the number of people susceptible to HBV infection. To evaluate the epidemiological and molecular features of HBV infection among recyclable waste collectors. The participants were recruited from the dumping ground and recycling cooperatives in Campo Grande, Brazil, and were screened for hepatitis B and C, and HIV serological markers by ELISA, confirmed by PCR. Among 278 participants, 63.7% (95% CI: 58.0–69.3) were considered susceptible to HBV infection. The prevalence rate of HBV exposure was 10.1% (95% CI: 6.5–13.6) and 0.4% (95% CI: 0.1–0.6) were chronic carriers. Age ≥45 years (AOR=7.15), history of homosexual contact (AOR=5.29), tattoo (AOR=4.92) and history of surgery (AOR=2.89) were factors associated with ever infection. Age 18–25 years (AOR=4.63), educational level ≥9 years (AOR=1.98) and knowledge about HBV transmission (AOR=3.08) were associated with serological HBV vaccination like profile (26.2%; 95% CI: 21.1–31.4). Despite the availability and efficacy of HBV vaccine, this study found high HBV exposure and proportion of susceptible adults in a low endemic area. Vaccination and screening campaigns using accessible language to the economically disadvantaged populations can reduce the number of people susceptible to HBV infection.