Dramatic decline in acute hepatitis B infection and disease incidence rates among adolescents and young people after 12 years of a mass hepatitis B vaccination programme of pre-adolescents in the schools of Catalonia (Spain)

Salleras, L.; Domı́nguez, Àngela; Bruguera, Miquel; Cardeñosa, Neus; Batalla, J.; Carmona, Glòria; Navas, Encarna; Taberner, J.L.

doi:10.1016/j.vaccine.2005.01.068

Cited by 32 publications

(22 citation statements)

References 9 publications

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“…In this study, a low prevalence of HBV infection of 1.1% was verified, similar to that of adolescents and young adults from developed countries, where hepatitis B vaccination programs are fully implemented, such as Italy (0.9%) 19 , Spain (0.9%) 20 and the United States (1%) 21 , and that verified in a nationwide study in northeastern and central-western Brazil (1.3%) 22 and by our group in the metropolitan area of Florianópolis, Santa Catarina, Brazil (0.5%) 23 . In contrast, this prevalence is lower than that of Greece (2.5%) 24 and of developing regions, where HBV vaccination programs are only partially implemented or not implemented at all, such as Mexico (5%) 25 , Bolivia (6.9%) 26 and central Brazil (5.9%) 27 .…”

Section: Ethical Considerationssupporting

confidence: 70%

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Hepatitis B marker seroprevalence and vaccination coverage in adolescents in the City of Itajaí, State of Santa Catarina, Southern Brazil, in 2008

Tonial

Passos

Livramento

et al. 2011

Rev. Soc. Bras. Med. Trop.

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Introduction: Hepatitis B infection constitutes an important cause of morbidity and mortality worldwide. In Brazil, however, the current epidemiological situation is not clear. Considering the importance of establishing this prevalence, the aim of this study was to determine the prevalence of HBV markers in voluntary adolescents, junior high (secondary school) students, in the City of Itajaí, State of Santa Catarina, Brazil. Methods: A seroepidemiological, transverse study was conducted with 353 randomly chosen adolescents from elementary school in 2008. Blood samples were analyzed for HBsAg, anti-HBc and anti-HBs. All analyses were conducted by automated microparticle enzyme immunosorbent assay (Abbott®, AxSYM system, Deerfield, IL, USA), according to the manufacturer's instructions. Results: The prevalence of HBsAg was 0.6% (CI 95% 0.1 -2.0), that of anti-HBc was 1.1% (CI 95% 0.3 -2.9) and that of detectable anti-HBs was 83.6% (CI 95% 79.3 -87.3). Hepatitis B vaccination coverage was 97.5% (CI 95% 95.2 -98.8). Conclusions: These results demonstrate the success of the vaccination program against hepatitis B in the region studied and indicate that prevention strategies must be maintained and, if possible, expanded to contribute to the establishment of positive prevalence rates in all age groups.

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Section: Ethical Considerationssupporting

confidence: 70%

“…Moreover, this age group is expected to be less exposed to risk factors of transmission, such as intravenous drug use, blood transfusions and occupational infection 20 .…”

Section: Ethical Considerationsmentioning

confidence: 99%

Hepatitis B marker seroprevalence and vaccination coverage in adolescents in the City of Itajaí, State of Santa Catarina, Southern Brazil, in 2008

Tonial

Passos

Livramento

et al. 2011

Rev. Soc. Bras. Med. Trop.

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“…30,31 Observational studies in British Columbia, Quebec and Catalonia, Spain, suggest that universal vaccination of preadolescent or adolescent children reduces the incidence of HBV during adolescence. 1,32,33 Similar to the results from studies of programs involving infants, these results may have been affected by changes in hygiene practices in hospitals and in the community, which may have lead to an overestimation of the effectiveness of the immunization programs. Authors of the Spanish study suggest that improved reporting may have lead to an underestimation of vaccine effectiveness in their jurisdiction, and the Canadian authors state that reporting did not change significantly over the course of their studies.…”

Section: Universal Vaccination Of Adolescentsmentioning

confidence: 61%

“…Authors of the Spanish study suggest that improved reporting may have lead to an underestimation of vaccine effectiveness in their jurisdiction, and the Canadian authors state that reporting did not change significantly over the course of their studies. 1,32,33 Table 3 summarizes the results of long-term studies in adolescents.…”

Section: Universal Vaccination Of Adolescentsmentioning

confidence: 99%

“…37 Data from passive reporting systems in Spain and Canada suggest that as HBV rates drop in countries where universal vaccination is offered, immigration is becoming a more important factor in incidence and prevalence. 1,33 Many jurisdictions where universal HBV vaccination is offered to adolescents, including some Canadian provinces, also target infants born to mothers positive for HBV. A Cochrane meta-analysis reported that hepatitis B immune globulin given immediately after birth, in addition to an early vaccine series, can dramatically reduce the risk of vertical transmission.…”

Section: Universal Vaccination Of Adolescentsmentioning

confidence: 99%

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Hepatitis B immunization strategies: timing is everything

Mackie¹,

Buxton²,

Tadwalkar³

et al. 2009

Canadian Medical Association Journal

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Chronic HBV infection, with the attendant risk of cirrhosis and hepatocellular carcinoma, occurs in 1%-5% of adults and up to 90% of infants who are infected with HBV.3-5 Providing vaccinations during adolescence without offering vaccinations during infancy misses this critical period when the acquisition of a HBV infection can be the most harmful. Epidemiologic studies show that the age distribution of HBV varies by jurisdiction and suggest that roughly one-third of chronic infections are acquired during infancy and early childhood.6-9 An ideal vaccine schedule should protect against infection both in infancy, when the risk of becoming a chronic HBV carrier is highest, and in adolescence, when high-risk sexual and drugusing behaviours occur more frequently.Epidemiologic data are critical for informing decisions about vaccination. Estimating the age-specific incidence of acute infections is valuable for planning prevention measures. However, acute infections in infants and toddlers may be missed because HBV infection is often asymptomatic in young children. In many jurisdictions, the age-specific incidence of HBV infection is unknown.The controversy surrounding booster injections stems in part from the rapid drop in antibodies after completion of the primary series of injections. Serum levels of antibodies against hepatitis B surface antigen have been used to measure the initial response to vaccination (antibody levels ≥ 10 IU/L are considered protective). This marker measures response to the vaccine within the first few weeks but is not an appropriate indicator of long-term immunity. Serologic studies have shown that the titre of antibodies against hepatitis B surface antigen drops within the first few years after vaccination and that one-third to one-half of children vaccinated as infants will have titres below 10 IU/L by 10-15 years of age. [10][11][12] This has been misinterpreted to mean that population-level protection shows a similar dramatic drop.Long-term observational data show that vaccinated individuals -even those who have an undetectable titre of hepatitis B surface antigen -can mount an anamnestic response to contact with HBV.11,13 A recent booster trial performed 18 years after vaccination of infants in Gambia provides further evidence of persistent immunity.14 Although almost 70% of participants had no detectable antibodies at baseline, of the 181 participants who were tested 2 weeks after receiving a booster dose, 92.3% (95% CI 87.4-95.7) showed an early anamnestic response.14 The geometric mean concentration of antibodies against hepatitis B surface antigen in this group rose to 524 IU/L (95% CI 441-621), which suggests that most people who have been vaccinated can mount a protective immune response even 18 years after receiving a primary series of vaccinations in infancy. Universal vaccination of infantsAs of 2007, 171 of the 193 member countries of the World Health Organization (WHO) had implemented the recommendations of the Expanded Programme on Immunization to offer universal hepatitis B ...

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Hepatitis B and D

Lok

Negro

2011

Schiff's Diseases of the Liver

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Dramatic decline in acute hepatitis B infection and disease incidence rates among adolescents and young people after 12 years of a mass hepatitis B vaccination programme of pre-adolescents in the schools of Catalonia (Spain)

Cited by 32 publications

References 9 publications

Hepatitis B marker seroprevalence and vaccination coverage in adolescents in the City of Itajaí, State of Santa Catarina, Southern Brazil, in 2008

Hepatitis B marker seroprevalence and vaccination coverage in adolescents in the City of Itajaí, State of Santa Catarina, Southern Brazil, in 2008

Hepatitis B immunization strategies: timing is everything

Hepatitis B and D

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