Hepatitis B vaccination has dramatically reduced infection rates among children in Europe, but more is needed to achieve elimination

The introduction of the hepatitis B vaccine in 1982 led to a dramatic fall in the prevalence of hepatitis B virus (HBV) infections globally. Today, 4.5 million infections are prevented each year in children, as the first WHO “Global hepatitis report 2017” revealed last week.

The WHO European Region has contributed to the worldwide decline in HBV infections by reaching a prevalence of 0.4% in children under 5, thus achieving one of the targets of the first Action plan for the health sector response to viral hepatitis in the WHO European Region. Most of the 15 million people in the Region living with the disease are adults born before the hepatitis B vaccine became widely available in the 1990s.

Both the European Vaccine Action Plan, adopted in 2014, and the Action plan for the health sector response to viral hepatitis in the WHO European Region, adopted in 2016, call for the control of HBV through vaccination. While the prevalence target of no more than 0.5% has been met for the Region, other targets have not yet been achieved.

First year of life critical to preventing HBV infection

WHO recommends vaccination with the first dose of hepatitis B vaccine within the first 24 hours of life. This is one of the most effective measures for preventing early infection. However, some countries with low circulation of HBV target only newborns of women with chronic infection.

Countries that implement universal newborn vaccination should ensure at least 90% coverage with a timely birth dose of hepatitis B vaccine. Countries that target vaccination to at-risk newborns only should aim to screen all pregnant women, including among undocumented migrant populations and marginalized groups.

WHO recommends reaching every child with 3 doses of hepatitis B vaccine

Following the vaccine given at birth, children need to complete immunization with 2 additional shots. Another target of the Action plan is to reach 95% coverage with all 3 doses of hepatitis B vaccine.

Immunization of all children with the recommended 3 doses of hepatitis B vaccine will:

• protect people at every stage of life, as young children who become infected with HBV are at high risk of severe complications later in life; and
• prevent HBV transmission in all age groups by creating broad population-based immunity.

As of April 2017, 47 of the 53 countries in the Region conduct universal hepatitis B vaccination, with 26 countries vaccinating all newborns and 21 starting vaccination from 2 months or later. The United Kingdom plans to start providing protection against HBV infection to all infants born after 1 August 2017.

All countries should seek to achieve universal childhood vaccination against HBV. This should be complemented by catch-up vaccinations for older age groups and for adults at high risk of HBV infection, including health care workers, people who inject drugs, men who have sex with men, and others according to the local context.

About HBV

HBV is a virus that attacks the liver and can cause both acute and chronic disease. It is transmitted through contact with the blood or other body fluids of an infected person.

Over 90% of healthy adults infected with HBV recover naturally within the first year. This is not commonly the case for children infected before reaching their fifth birthday, particularly if they are infected in their first year of life. These children are more likely to develop chronic infections that often lead to serious complications decades later, such as cirrhosis and liver cancer.

European Immunization Week 2017

On 24–30 April 2017, the Region celebrates European Immunization Week, an annual initiative that raises awareness of the importance of immunization for people’s health and well-being. This year, under the slogan #VaccinesWork, stakeholders in all countries focus on the importance and benefits of immunization at every stage of life.