The effectiveness of the national hepatitis B vaccination program 25 years after its introduction in Iran: a historical cohort study

Moghadami, Mohsen; Dadashpour, Nazanin; Mokhtari, Ali Mohammad; Ebrahimi, Mostafa; Mirahmadizadeh, Alireza

doi:10.1016/j.bjid.2019.10.001

Cited by 27 publications

(23 citation statements)

References 36 publications

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“…Increasing vaccination coverage was followed by a sharp decline in cirrhosis caused by chronic hepatitis B since 2001. 29 Another example is the success of the mumps-measles-rubella mass vaccination that reached more than 96·4% in 2008. 30 Certain diseases have been systematically controlled with concerted efforts; for example, malaria ( p vivax ) has been largely controlled, with Iran in the WHO pre-elimination phase, with a directly observed therapy method in the PHC network.…”

Section: Resultsmentioning

confidence: 99%

Health system performance in Iran: a systematic analysis for the Global Burden of Disease Study 2019

Farzadfar¹,

Naghavi²,

Sepanlou³

et al. 2022

The Lancet

151

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Section: Resultsmentioning

confidence: 99%

Health system performance in Iran: a systematic analysis for the Global Burden of Disease Study 2019

Farzadfar¹,

Naghavi²,

Sepanlou³

et al. 2022

The Lancet

151

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“…Our findings add substantially to current evidence on hepatitis B VE in the universal childhood vaccination age. [ 5,7,8,10 ] The previous studies were all from countries with high endemicity of HBV, with relatively small sample sizes ranging from 753 in the Gambian study [ 10 ] to 2720 in the Iranian study [ 8 ] ; and our study reports VE against any HBV infection in countries with low endemicity and has the largest sample size so far ( n = 16,505; born 1991–2012). The finding from our study was expected following the successful implementation of the universal childhood immunization program since 1991.…”

Section: Discussionmentioning

confidence: 98%

The impact of hepatitis B vaccination in the United States, 1999–2018

Guan

2021

Hepatology

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Background and Aims Hepatitis B vaccine has been included in the infant immunization schedule since 1991 in the United States. We aimed to assess its effectiveness against HBV infection and its impact on mortality. Approach and Results The study population was participants aged 6+ years with an HBV vaccination history and an HBV serologic test from the National Health and Nutrition Examination Survey, 1999–2018. Participants aged 18+ years with linked mortality records from 1999–2014 were followed for mortality analysis. Multivariable logistic regression was used to compute vaccine effectiveness (VE) overall, by year of birth, and by age. Cox regression was used to estimate HRs for all‐cause, cancer‐related, and cardiovascular disease–related mortality. A total of 64,107 participants were included in the main analysis, with 29,600 (40.7%) having completed HBV vaccination (three or more doses, vaccinated). The highest vaccination uptake was found among those born after 1991, at 86.5%. Vaccinated participants had higher prevalence of vaccine‐induced immunity than the unvaccinated (47.2% vs. 7.4%). Among those born after 1991, VE was found at 58% (95% CI, 18%–79%) overall and 85% for those aged ≥20 years (mean age, 22), whereas no effect was found among those born prior to 1990. HBV vaccination was associated with reduced risk of all‐cause mortality (HR, 0.78; 95% CI, 0.68–0.90) and cancer‐related mortality (HR, 0.76; 95% CI, 0.58–1.00) but not for cardiovascular disease–related mortality. Conclusions In the universal infant vaccination era, the HBV vaccine has shown substantial effectiveness against HBV infection and maintained strong protection for 20 years. It was also associated with reduced risk of all‐cause and cancer‐related mortality.

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“…In the case of hepatitis B, the rate of infection was similar to the general population rate of about 1.09%. 27 Considering the vast coverage of national vaccination from 1993 in Iran, 28 the mean age of prisoners and receiving HBV vaccine upon entrance to prison, this finding was expected.…”

Section: Discussionmentioning

confidence: 89%

Seroprevalence of Hepatitis C Virus among Prisoners in Lakan Prison, North of Iran, Is There Still a Concern?

Mohtasham-Amiri

Rezvani

Ashoori³

et al. 2021

Arch Iran Med

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Background: Hepatitis C is a major cause of liver failure and liver transplantation. The known risk factors of this disease include blood transfusion, injection drug use, high risk sexual behaviors, tattoos, and use of shared blades and syringes. Due to the higher risk of viral hepatitis among people in prison, this study was done to find the seroprevalence of hepatitis C virus (HCV) and associated risk factors in Lakan Prison in Rasht. Methods: Prisoners in Lakan Prison underwent a cross-sectional study in 2018. A questionnaire containing demographic information and risk factors was distributed to the inmates and they were asked complete them. High-risk individuals were selected and a blood sample was taken and tested. Data were collected and analyzed by SPSS18 software. Results: Out of 2215 prisoners, 1238 people had at least one risk factor, of whom 408 individuals were selected by random sampling. One hundred inmates were positive for anti-HCV antibody, yielding a prevalence of 24.5% (95% CI: 20.4%–28.7%) of whom 42.6% were people who injected drugs and 4 cases were found positive for the hepatitis B surface antigen, yielding a 1% prevalence (95% CI, 0.2%–2%.). A history of injecting drug use (OR 4.28, 95% CI: 2.55–7.17), and previous history of imprisonment (OR 2.94, 95% CI: 1.34–6.53) had association with HCV infection. Conclusion: The present study shows that hepatitis C is prevalent in prisons and preventive and screening programs should be implemented with necessary training for inmates.

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The effectiveness of the national hepatitis B vaccination program 25 years after its introduction in Iran: a historical cohort study

Cited by 27 publications

References 36 publications

Health system performance in Iran: a systematic analysis for the Global Burden of Disease Study 2019

Health system performance in Iran: a systematic analysis for the Global Burden of Disease Study 2019

The impact of hepatitis B vaccination in the United States, 1999–2018

Seroprevalence of Hepatitis C Virus among Prisoners in Lakan Prison, North of Iran, Is There Still a Concern?

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