title: Near elimination of hepatitis B virus infections among Hawaii elementary school children after universal infant hepatitis B vaccination.
abstract: OBJECTIVE
  Hawaii implemented routine infant hepatitis B vaccination in 1992 and required it for school entry in 1997. Previously, in 1989, a serologic survey among Hawaii school children in grades 1 to 3 indicated that 1.6% had chronic hepatitis B virus infection, and 2.1% had resolved infection. We conducted a follow-up survey to examine changes in hepatitis B virus infection rates.
  
  
  METHODS
  This study was performed in Oahu, Hawaii, during the 2001-2002 school year among children in grades 2 and 3. Consenting parents/guardians provided demographic information including place of birth. Participants were tested for serologic evidence of hepatitis B virus infection and their vaccination status was determined by reviewing school records. Rates of symptomatic acute hepatitis B among persons aged < or = 19 years were calculated from cases reported from Hawaii to the Centers for Disease Control and Prevention between 1990 and 2004.
  
  
  RESULTS
  Completed hepatitis B vaccination series were documented for 83% of the 2469 participants by age 18 months and for 97% by age 5 years. Past or present hepatitis B virus infection was detected among 6 participants (0.24%), including 1 (0.04%) with chronic infection and 5 (0.20%) with resolved infections. Compared with the 1989 survey, these prevalences represent declines of 97% and 90% in chronic and resolved hepatitis B virus infections, respectively. The incidence of symptomatic acute hepatitis B in Hawaii children and adolescents aged < or = 19 years decreased from 4.5 cases per 100,000 in 1990 to 0.0 during 2002-2004. To date, the last reported case in a child aged < 15 years in Hawaii occurred in 1996.
  
  
  CONCLUSIONS
  Hepatitis B virus infection has nearly been eliminated in Hawaii children born after universal infant hepatitis B vaccination was implemented. These findings suggest that hepatitis B prevention goals are being met through routine immunization and related prevention programs among US children.
authors.affiliation: Division of Viral Hepatitis, Centers for Disease Control and Prevention, Department of Health and Human Services, 1600 Clifton Rd, Mailstop G-37, Atlanta, GA 30333, USA. jperz@cdc.gov
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Perz
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Elm
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Fiore
authors.forename: Janice I
authors.initials: JI
authors.lastname: Huggler
authors.forename: Wendi L
authors.initials: WL
authors.lastname: Kuhnert
authors.forename: Paul V
authors.initials: PV
authors.lastname: Effler
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006254:Hawaii / Q000453:epidemiology; D006291:Health Policy; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006801:Humans; D017589:Immunization Programs; D015994:Incidence; D008297:Male; D016036:Seroepidemiologic Studies
chemical_list: D017325:Hepatitis B Vaccines