Evaluation of the impact of hepatitis B vaccination among children born during 1992-2005 in China.
BACKGROUND
Endemic hepatitis B virus (HBV) infection is a serious health problem in China. Hepatitis B vaccination of infants was introduced in 1992 and was progressively expanded during the subsequent 15 years.


METHODS
We conducted a national serosurvey, with participants selected by multiple-stage random sampling. Demographic characteristics and hepatitis B vaccination history were collected by a questionnaire and a review of vaccination records, and serum specimens were tested for hepatitis B surface antigen, antibody to hepatitis B core antigen, and hepatitis B surface antibody by enzyme-linked immunosorbent assay.


RESULTS
Hepatitis B vaccine coverage (3 doses) increased from 30.0% for children born in 1992 to 93.4% for children born in 2005. Receipt of a timely birth dose increased from 22.2% to 82.6% for children born during this interval. Multivariate analysis showed that older age, western and rural residence, birth at home, and certain ethnicities were risk factors for under vaccination with both full vaccine series and timely birth dose. The prevalence of hepatitis B surface antigen was reduced to 2.1% among all children and 1.0% among children born after 1999. The efficacy of hepatitis B vaccination with a timely birth dose was 88.3%.


CONCLUSIONS
Hepatitis B vaccine has been successfully integrated into routine infant immunization in China, now reaching most infants within 24 h after birth, and the prevalence of hepatitis B surface antigen has been greatly reduced among children born after 1992.
Liang
Xiaofeng
X
Chinese Center for Disease Control and Prevention, Beijing, China.
Bi
Shengli
S
Yang
Weizhong
W
Wang
Longde
L
Cui
Gang
G
Cui
Fuqiang
F
Zhang
Yong
Y
Liu
Jianhua
J
Gong
Xiaohong
X
Chen
Yuansheng
Y
Wang
Fuzhen
F
Zheng
Hui
H
Wang
Feng
F
Guo
Jing
J
Jia
Zhiyuan
Z
Ma
Jingchen
J
Wang
Huaqing
H
Luo
Huiming
H
Li
Li
L
Jin
Shuigao
S
Hadler
Stephen C
SC
Wang
Yu
Y
D002681:China / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control / Q000635:transmission; D017325:Hepatitis B Vaccines / Q000276:immunology* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology / Q000517:prevention & control / Q000821:virology; D012424:Rural Population; D014505:Urban Population
D017325:Hepatitis B Vaccines