Impact of hepatitis B vaccination on acute hepatitis B epidemiology in European Union/European Economic Area countries, 2006 to 2014

Abstract

Hepatitis B prevention in European Union/European Economic Area (EU/EEA) countries relies on vaccination programmes. We describe the epidemiology of acute hepatitis B virus (HBV) at country and EU/EEA level during 2006–2014. Using a multi-level mixed-effects Poisson regression model we assessed differences in the acute HBV infection notification rates between groups of countries that started universal HBV vaccination before/in vs after 1995; implemented or not a catch-up strategy; reached a vaccine coverage ≥ 95% vs < 95% and had a hepatitis B surface antigen prevalence ≥ 1% vs < 1%. Joinpoint regression analysis was used to assess trends by groups of countries, and additional Poisson regression models to evaluate the association between three-dose HBV vaccine coverage and acute HBV infection notification rates at country and EU/EEA level. The EU/EEA acute HBV infection notification rate decreased from 1.6 per 100,000 population in 2006 to 0.7 in 2014. No differences (p > 0.05) were found in the acute HBV infection notification rates between groups of countries, while as vaccine coverage increased, such rates decreased (p < 0.01). Countries with universal HBV vaccination before 1995, a catch-up strategy, and a vaccine coverage ≥ 95% had significant decreasing trends (p < 0.01). Ending HBV transmission in Europe by 2030 will require high vaccine coverage delivered through universal programmes, supported, where appropriate, by catch-up vaccination campaigns.

Hepatitis B and C prevalence and incidence in key population groups with multiple risk factors in the EU/EEA: a systematic review

“…Vaccination policies in different countries or prisons are also likely to impact the prevalence of HBV infection. Universal routine HBV vaccination in childhood is currently implemented in the majority of EU countries, and increasing vaccine coverage in countries has been significantly associated with decreasing acute HBV notification rates [34]. However, depending on the year when a vaccination programme has been introduced in a country, this may have had a different impact on the cohorts of individuals entering into prison.…”

Acute hepatitis B notification rates in Flanders, Belgium, 2009 to 2017

“…However, the acute hepatitis B notification rates from 2009 to 2017 in Flanders showed a downward trend. In the European Union, the average annual acute hepatitis B notification rate between 2006 and 2014 was 1.0 per 100,000 population [36]. The surveillance data for acute hepatitis B notification rates in Flanders were therefore comparable with other European countries, although direct comparison between countries is not possible considering the heterogeneity in acute hepatitis B case definitions and reporting systems.…”

Hepatitis B and C among healthcare workers and patient groups at increased risk of iatrogenic transmission in the European Union/European Economic Area

“…The impact of childhood HBV vaccination programmes, well-established in the EU/EEA region [67] , have been largely unaccounted for in the included studies, although it may be inferred from the lower prevalence seen for HBV as compared to HCV. Data on vaccination programmes and their coverage should be considered alongside prevalence when assessing the needs for and developing targeted testing initiatives at country level.…”