Public Health

Vaccination has nearly eliminated hepatitis B infections in Hawaiian children

Last Updated: 2006-10-16 15:56:47 -0400 (Reuters Health)

By Will Boggs, MD

NEW YORK (Reuters Health) - Hepatitis B virus (HBV) infections among elementary school children in Hawaii fell by more than 90% after universal infant hepatitis B vaccination was implemented, according to a report in the October issue of Pediatrics.

"This is a success story, and helps to show how far we've come since 1991 when ACIP first recommended routine infant hepatitis B immunization and related activities, including perinatal infection prevention programs," Dr. Joseph F. Perz from Centers for Disease Control and Prevention, Atlanta, Georgia told Reuters Health.

Dr. Perz and colleagues tested two cohorts of elementary school children for serologic evidence of hepatitis B virus infection and examined rates of symptomatic acute hepatitis B before and after institution of routine hepatitis B vaccination.

The prevalence of chronic HBV infection decreased from 1.6% to 0.04% (a by 97% reduction), after routine HBV vaccination began, the authors report, and the prevalence of resolved infection fell by 90%,from 2.1% to 0.20%.

The rate of new cases of acute hepatitis B in Hawaii children and adolescents declined from 4.5 cases per 100,000 in 1990 (before vaccination) to 0.0 cases during 2002-2004, the researchers note. The last case of acute hepatitis B in a child under age 15 years was reported in 1996.

"These data provide important evidence that hepatitis B prevention goals are being met among US children through routine hepatitis B immunization and related activities, including perinatal infection prevention programs," the investigators conclude.

"As a consequence," the authors add, "adults who were vaccinated as children should benefit from corresponding reductions in HBV-related chronic liver disease and mortality from cirrhosis and hepatocellular carcinoma."

"Data from the 2005 National Immunization Survey (released last month: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5536a2.htm) showed that among U.S. children aged 19-35 months, a 92.9% hepatitis B vaccine completion rate had been achieved nationally," Dr. Perz added.

"Nonetheless," he commented, "there is room for improvement as reflected in the updated ACIP strategy for eliminating HBV transmission in the U.S. (made public in December 2005: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5416a1.htm)."

Pediatrics 2006;118:1403-1408.