A significant reduction in hepatitis B virus infection among the children of Shandong Province, China: the effect of 15 years of universal infant hepatitis B vaccination

Objective: To evaluate the effect of the universal infant hepatitis B vaccination program on hepatitis B infection in China. Methods: In 2006, a survey was conducted in Shandong Province, China, among children aged 1-14 years, 15 years after the introduction of universal infant hepatitis B vaccination. The subjects were selected by stratified, multi-stage sampling. Vaccination history was obtained by immunization certificate (when available) or parent recall. Hepatitis B surface antigen (HBsAg) and antibodies to HBsAg (anti-HBs) and core antigen (anti-HBc) were detected by ELISA. Hepatitis B infection was defined as the presence of HBsAg and/or anti-HBc. The prevalence rates of HBsAg, anti-HBs and hepatitis B infection obtained in this survey were compared with the results of a survey conducted in 1992 (prior to universal vaccination). Results: A total of 3738 children aged 1-14 years were included in the final analysis. A vaccination coverage rate of 93% was achieved in 2006. The prevalence rates of HBsAg and hepatitis B infection decreased from 8% and 46% in the 1992 survey to 1% and 4%, respectively, in the 2006 survey. Conclusions: Universal hepatitis B vaccination in infants can result in a 90.47% reduction in hepatitis B infection in children aged 1-14 years. (C) 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.