Association of vaccine policy with virus infection and awareness of hepatitis B in Fujian, China

Abstract

China has regulated its hepatitis B vaccination policy. However, data on the prevalence of hepatitis B virus (HBV) infection have not been updated since 2014. In addition, the impact of the policy on awareness of hepatitis B is limited, especially in Fujian Province where HBV infection is highly prevalent. We conducted a sero-epidemiological survey in five national monitoring counties to address these concerns. A total of 5,873 subjects were included and classified into four birth cohorts according to the policy time nodes (1981, 1992, and 2002). The HBsAg carrier rate for the general population was 8.6% (95% confidence interval [CI]: 7.9–9.3). Compared with those born before 1981, adjusted odds ratios (OR) for HBV infection were 0.51 (95% CI: 0.43–0.62), 0.10 (0.08–0.12), and 0.015 (0.01–0.023) among the 1981–1991, 1992–2001, and ≥2002 birth cohorts, respectively; while the OR was 1.26 (1.00–1.57), 0.39 (0.26–0.58), and 0.019 (0.006–0.06) for HBsAg carriage, respectively. Among the 4865 residents aged ≥15 years, hepatitis B awareness has been declining since the introduction of the hepatitis B vaccine into the immunization program (β = −0.25, SE = 0.08, P = .001, and β = −0.20, SE = 0.08, P = .017 for 1992–2001 and ≥2002 birth cohort, respectively). This decline was obvious for the initiation time of the first dose of the hepatitis B vaccine. Although the hepatitis B vaccination policies have helped reduce the infection, the awareness has declined. More measures on the target population are warranted to improve the public’s awareness of hepatitis B vaccination in the context of great achievements.

Post-Vaccination and Post-Infection Immunity to the Hepatitis B Virus and Circulation of Immune-Escape Variants in the Russian Federation 20 Years after the Start of Mass Vaccination

“…This latter figure is surprisingly high, contrasting, for instance, with the zero anti-HBc prevalence in the 12–14 years age group, and the 71% reduction among those aged 15–19 years reported in Australia a decade after the start of universal vaccination [ 21 ], or drop to below 1% observed in Italian recruits 30 years following the start of universal vaccination [ 22 ]. Notably, vaccination may not lead to a complete cessation of HBV circulation even in non-endemic countries, which is reflected by a non-zero anti-HBc antibody detection rates, but its prevalence demonstrates a significant reduction over time, as was reported in studies from the United States, the European Union, and China [ 23 , 24 , 25 ]. Our data on stable anti-HBc detection rates indicate ongoing HBV circulation in the vaccinated generation and the possibility of transient infection in vaccinated individuals that does not result in establishing HBsAg persistence.…”