title: Nationwide hepatitis B vaccination program in Taiwan: effectiveness in the 20 years after it was launched.
abstract: The national hepatitis B vaccination program in Taiwan is considered one of the most successful and effective public health programs to control chronic hepatitis B infection in the past 20 years. This review illustrates how to implement a successful hepatitis B vaccination program based on Taiwan's experience. Several important controlled randomized clinical trials on hepatitis B immunoglobulin and vaccine in Taiwan demonstrated an 80-90% protective effect among infants of mothers who were positive for either hepatitis B envelope antigen or hepatitis B surface antigen. A series of prevalence surveys on children born before and after the national vaccination program began disclosed a steady decrease in seroprevalence of hepatitis B surface antigen in Taiwan, with 78-87% effectiveness after the national vaccination program was launched. Studies on the secular trend of liver disease risk also documented a 68% decline in mortality from fulminant hepatitis in infants and a 75% decrease in the incidence of hepatocellular carcinoma in children 6-9 years of age after the national vaccination program began. In conclusion, since 1984, the national hepatitis B vaccination program has been successful in preventing acute and chronic liver diseases in Taiwan.
authors.affiliation: Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan. cjchen@ha.mc.ntu.edu.tw
authors.forename: Yin-Chu
authors.initials: YC
authors.lastname: Chien
authors.forename: Chyi-Feng
authors.initials: CF
authors.lastname: Jan
authors.forename: Hsu-Sung
authors.initials: HS
authors.lastname: Kuo
authors.forename: Chien-Jen
authors.initials: CJ
authors.lastname: Chen
mesh_terms: D002648:Child; D003140:Communicable Disease Control / Q000458:organization & administration*; D006510:Hepatitis B Antibodies / Q000097:blood / Q000276:immunology; D006511:Hepatitis B Antigens / Q000097:blood / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000600:supply & distribution; D006515:Hepatitis B virus / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D009313:National Health Programs; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D016036:Seroepidemiologic Studies; D013624:Taiwan / Q000453:epidemiology
chemical_list: D006510:Hepatitis B Antibodies; D006511:Hepatitis B Antigens; D017325:Hepatitis B Vaccines