Abstract
Universal hepatitis B vaccination of newborns was implemented in Russia starting from 1998. From 1998 to 2019, the incidence of acute hepatitis B reduced from 43.8 to 0.57 cases per 100,000 population. Here, we assessed the timely coverage of newborns with the birth dose (HepB-BD), second dose (HepB-2nd), and three vaccine doses (HepB3) in two remote regions of Russia with low (Belgorod Oblast) and high (Yakutia) levels of hepatitis B virus (HBV) endemicity. Vaccination data were obtained from the medical records of 1000 children in Yakutia and 2182 children in Belgorod Oblast. Sera of healthy volunteers from Belgorod Oblast (n = 1754) and Yakutia (n = 1072) across all age groups were tested for serological markers of HBV to assess the infection prevalence and herd immunity. Average HepB-BD coverage was 99.2% in Yakutia and 89.4% in Belgorod Oblast (p < 0.0001) and in both regions varied significantly, from 66% to 100%, between medical centers. The principal reason for the absence of HepB-BD was parent refusal, which accounted for 63.5% of cases of non-vaccination (83/123). While timely HepB-2nd coverage was only 55.4%–64.7%: HepB3 coverage by the age of one year exceeded 90% in both study regions. HBV surface antigen (HBsAg) prevalence in the 1998–2019 birth cohort was 0.2% (95% CI: 0.01–1.3%) in Belgorod Oblast and 3.2% (95% CI: 1.9–5.2%) in Yakutia. The proportion of persons testing negative for both antibodies to HBsAg (anti-HBs) and antibodies to HBV core antigen (anti-HBc) in the 1998–2019 birth cohort was 26.2% (125/481) in Belgorod Oblast and 32.3% (162/501) in Yakutia. We also assessed the knowledge of and attitude towards vaccination among 782 students and teachers of both medical and non-medical specialties from Belgorod State University. Only 60% of medical students knew that hepatitis B is a vaccine-preventable disease. Both medical and nonmedical students, 37.8% and 31.3%, respectively, expressed concerns about safety and actual necessity of vaccination. These data indicate the need to introduce a vaccine delivery audit system, improve medical education with respect to vaccination strategies and policies, and reinforce public knowledge on the benefits of vaccination.
Highlights
Hepatitis B caused by human hepatitis B virus (HBV) is a widespread, socially significant infection causing up to 900,000 deaths annually, primarily due to the underlying liver disease culminating in liver cirrhosis and hepatocellular carcinoma (HCC) [1]
We showed that vaccination against hepatitis B in several regions of Russia, including Yakutia, led to a significant decrease in the incidence and prevalence of HBV in the general population and the number of expected unfavorable outcomes of the infection [10]
Our observations are supported by the lack of knowledge about hepatitis B vaccination and fears of vaccination demonstrated in the representative interviews done among medical students and teachers
Summary
Hepatitis B caused by human hepatitis B virus (HBV) is a widespread, socially significant infection causing up to 900,000 deaths annually, primarily due to the underlying liver disease culminating in liver cirrhosis and hepatocellular carcinoma (HCC) [1]. The most effective approach to control hepatitis B is universal newborn vaccination, with the first dose administered 24 h after birth. Within the framework of this project, free vaccination against hepatitis B was offered to all children, adolescents and adults under the age of 60. As a result of the project, by 2013 the coverage by three doses of hepatitis B vaccine reached 97% in children under 18, and 72% in adults aged 18–59 years [3]. This has led to a sharp decline in the incidence of acute hepatitis B, in other words, the number of new HBV infections. Analysis of the effectiveness of the already implemented measures and recommendations of additional interventions are needed to achieve the World Health Organization (WHO) hepatitis elimination goals defined as 90% reduction in the incidence and 65% reduction in the mortality compared with the baseline of 2015 [5]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
