Efficacy of hepatitis B vaccine in the Gambian expanded programme on immunisation

Fortuin, M.; Chotard, J.; Jack, A; Maine, N.; Mendy, Maimuna; Hall, Andrew J.; Inskip, Hazel; George, M.O.; Whittle, Hilton

doi:10.1016/0140-6736(93)93137-p

Cited by 83 publications

(53 citation statements)

References 9 publications

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“…Vaccine efficacy did not significantly change over time and was 84% against infection and 94% against chronic carriage at 9 years of age. No difference in efficacy was observed between the four ecological zones (11,12).…”

Section: Ghis Design Implementation and Main Resultsmentioning

confidence: 87%

“…Of the vaccinated children, 98% achieved that level of protection (Table 1). In contrast to the initial assumption, protective responses did not depend on the number of vaccine doses received because >95% of children that received at least 1 dose responded to vaccination with anti-HBsAg titers z10 IU/mL and were protected against chronic carriage early in life (11,12,(16)(17)(18).…”

Section: Assumption 2: Hepatitis B Vaccine Efficacymentioning

confidence: 97%

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20 Years into the Gambia Hepatitis Intervention Study: Assessment of Initial Hypotheses and Prospects for Evaluation of Protective Effectiveness Against Liver Cancer

Viviani

Carrieri

Bah

et al. 2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Primary hepatocellular carcinoma is the commonest cancer in The Gambia. The Gambia Hepatitis Intervention Study (GHIS) was established in 1986 to evaluate the protective effectiveness of infant hepatitis B immunization in the prevention of chronic liver disease, particularly, hepatocellular carcinoma and cirrhosis later in adult life. This program was designed based on a series of assumptions. Here, we used data from observational and epidemiologic studies developed since 1986 to examine the validity of these assumptions. We found that (a) hepatitis B vaccine coverage was 15% more than originally assumed, (b) protection against hepatitis B virus (HBV) infection was not dependent on the number of vaccine doses received, (c) perinatal infection with HBV was of negligible importance, and (d) the HBV attributable risk of hepatocellular carcinoma at age <50 was 70% to 80%, lower than initially assumed. Based on these data, the final outcome of the GHIS should be measurable from 2017, sooner than originally assumed. The GHIS strategy takes into account-specific patterns of virus epidemiology and natural history of hepatocellular carcinoma in Africa and provides a model for integrating and evaluating new vaccines into the Expanded Programme of Immunization of sub-Saharan African countries. (Cancer Epidemiol Biomarkers Prev 2008;17(11):3216 -23)

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Section: Ghis Design Implementation and Main Resultsmentioning

confidence: 87%

Section: Assumption 2: Hepatitis B Vaccine Efficacymentioning

confidence: 97%

20 Years into the Gambia Hepatitis Intervention Study: Assessment of Initial Hypotheses and Prospects for Evaluation of Protective Effectiveness Against Liver Cancer

Viviani

Carrieri

Bah

et al. 2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…If children are protected against infection for the first five years of life, the population prevalence of hepatitis B carriage will be reduced. Studies using the simple strategy of integrating the vaccine into the routine Expanded Programme on Immunization show that a vaccine efficacy of 93% can be attained at 4 years of age (Fortuin et al 1993); further scrutiny of this population has shown that it is maintained at nine years of age. In Africa this means that routine vaccination of infants will reduce the prevalence of carriage from 15-20% to 1% or less.…”

Section: Editorial: We Have a Cancer Vaccine -Why Don't We Use It?mentioning

confidence: 99%

Editorial: We have a cancer vaccine – why don't we use it?

Hall

1998

Tropical Med Int Health

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“…The recombinant HepB is now incorporated in many different combinations vaccines, such as a pentavalent diphtheria, tetanus, pertussis, haemophilus influenza type B, and HepB (DTPHibHepB) combination vaccine and is also available in a monovalent formulation. HepB has been administered over a billion times and has both a very strong safety [7] and efficacy record [8][9][10][11][12][13]. Several country studies are available showing the effectiveness of HepB vaccination in reducing prevalence of chronic HBV infection, for example from Alaska [14], the Gambia [15], Italy [16], and Taiwan [17].…”

Section: Introductionmentioning

confidence: 99%

Estimating Coverage of Hepatitis B Birth Dose Vaccination: A Pilot Study in Western Pacific Countries

Burton¹

2013

J Vaccines Vaccin 2013

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Background: The universal administration of a birth dose of the hepatitis B vaccine within the first 24 hours of life is crucial for preventing perinatal hepatitis B virus transmission and can significantly reduce the disease burden of chronic hepatitis B infection. Unlike with the majority of vaccines recommended by WHO, there is currently no methodology to generate hepatitis B birth dose coverage estimates. Methods:Methods used by the WHO and UNICEF for estimating coverage for other vaccines were expanded to include indicators that allow validation of timeliness of administered hepatitis B birth doses in Western Pacific Countries. These indicators include percentages of births with skilled attendance or in health facilities and differences between WHO/UNICEF estimates and country-reported coverage for other vaccines. Results:We made hepatitis B birth dose estimates for 23 countries between 1999 and 2010. Estimates for the 2010 birth cohort ranged from 99% (eight countries) to as low as 2% (Viet Nam. Estimates for ten of 23 countries different from data reported by national authorities for at least one year. In some countries, the variability was as great as 50%. In several instances, estimates incorporating indicator data were different from those generated by the standard WHO/UNICEF protocol. Conclusions:A protocol for estimating hepatitis B birth dose coverage has been proposed and we have shown that supplemental indicator data can provide useful validation. Extrapolation to other regions will require availability of similar data.

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Efficacy of hepatitis B vaccine in the Gambian expanded programme on immunisation

Cited by 83 publications

References 9 publications

20 Years into the Gambia Hepatitis Intervention Study: Assessment of Initial Hypotheses and Prospects for Evaluation of Protective Effectiveness Against Liver Cancer

20 Years into the Gambia Hepatitis Intervention Study: Assessment of Initial Hypotheses and Prospects for Evaluation of Protective Effectiveness Against Liver Cancer

Editorial: We have a cancer vaccine – why don't we use it?

Estimating Coverage of Hepatitis B Birth Dose Vaccination: A Pilot Study in Western Pacific Countries

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