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Hepatitis B ControlStrategic Information and Country Profiles

© World Health Organization 2013

ISBN-13 978 92 9061 633 7

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CONTENTS

III

1. Abbreviations IV

2. Context 1

3. Regional Progress: Hepatitis B Control Milestones 2

4. Regional Progress: Chronic Hepatitis B Virus Prevalence 4

5. Regional Progress: Hepatitis B Vaccination Coverage, 1990 – 2011 6

6. Regional Progress: Status of the 2012 Hepatitis B Control Milestone 7

7. Country Profiles

American Samoa 8

Australia 9

BruneI Darussalam 10

Cambodia 11

China 12

Hong Kong (China) 13

Macao (China) 14

Cook Islands 15

Fiji 16

French Polynesia 17

Guam 18

Japan 19

Kiribati 20

Lao People’s Democratic Republic 21

Malaysia 22

Marshall Islands 23

Federated States of Micronesia 24

Mongolia 25

Nauru 26

New Caledonia 27

New Zealand 28

Niue 29

Northern Mariana Islands 30

Palau 31

Papua New Guinea 32

Philippines 33

Republic of Korea 34

Samoa 35

Singapore 36

Solomon Islands 37

Tokelau 38

Tonga 39

Tuvalu 40

Vanuatu 41

Viet Nam 42

Wallis and Futuna 43

ABBREVIATIONS

IV

AusAID Australian Agency for International DevelopmentBD Birth DoseCDC Centers for Disease Control and PreventionDHS Demographic and Health SurveyDTP3 Third dose of diphtheria-pertussis-tetanus vaccineGAVI Global Alliance for Vaccines and ImmunizationHB Hepatitis BHBV Hepatitis B virusHepB Hepatitis BHepB3 Third dose of hepatitis B vaccineHBsAg Hepatitis B surface antigen (a marker of hepatitis B infection)JRF Joint reporting formNZAID New Zealand Agency for International DevelopmentSBA Skilled birth attendantWHO World Health OrganizationUNICEF United Nations Children’s Fund

1

CONTEXT

1

Remarkable progress has been made in controlling hepatitis B infection in the Western Pacific Region. In 2005 the Regional Committee for the Western Pacific made a momentous decision to adopt the world’s first regional hepatitis B control goal. Resolution WPR/RC56.R8 set a goal of less than 1% hepatitis B prevalence among children with a milestone target of less than 2% prevalence by 2012. In 2012 the Region made history by achieving that milestone. The countries and areas of the Western Pacific Region have proven that a well-planned programme including evidence-based policies and careful performance measurement is a formula for success.

This document provides an overview of the hepatitis B control programme in the Western Pacific Region, and hepatitis B data profiles for the 36 countries and areas of the Region. The profiles include demographic data, vaccination policies, childbirth delivery types, reported vaccination coverage from 2008–2012, vaccination coverage and seroprevalence survey summaries, and the status of hepatitis B control verification. We are hopeful that this easy-to-ready snapshot of up-to-date data by country will be a useful tool for decision-makers in sustaining and increasing the important gains in hepatitis B control in the Western Pacific Region.

The Region has proven that suffering and death due to hepatitis B infection need not continue. Currently nine countries and areas have been verified as having reached the goal of less than 1% hepatitis B prevalence among five-year-old children. Let us continue to work together to ensure that all countries and areas achieve and sustain the goal of less than 1% hepatitis B prevalence among children, and that hepatitis B infection becomes a thing of the past.

PartnersGlobal action or recommendation

Regional action or recommendations

Country or regional progress

Key MilestonesHepatitis B (HB)

HB fact

Plasma-derived hepatitis B vaccine becomes the first ever cancer preventing vaccine licensed (the recombinant hepatitis B vaccine in use today was licensed in 1986).

AusAID, NZAID, WHO and UNICEF implement a project to increase hepatitis B vaccination in Pacific island countries.

GAVI support for hepatitis B vaccine introduction becomes available for GAVI-eligible countries.

WHO recommends hepatitis B birth dose vaccination for all newborn infants.

Hong Kong (China) and Malaysia verified as having reached the 1% hepatitis B control goal. Tonga verified as having reached the 2% hepatitis B control milestone.

2%

The Western Pacific Region as a whole and at least 30 countries and areas meet the 2% hepatitis B milestone.

Australia, China, Mongolia and New Zealand verified as having reached the 1% hepatitis B control goal.

The Western Pacific Region holds discussions on setting the target year for the 1% goal.

Palau verified as having reached the 1% hepatitis B control goal.

The Victorian Infectious Diseases Reference Laboratory (VIDRL) becomes the hepatitis B reference laboratory for the Western Pacific Region.

CDC supports WHO Regional Office for the Western Pacific in hepatitis B control.

The World Health Organization recommends hepatitis B vaccination for all infants.

Macao (China) and the Republic of Korea and are the first countries and areas officially verified as having reached the 1% hepatitis B control goal.

100%

All countries and areas in the Region include hepatitis B vaccination as part of their national immunization policies (Japan has targeted vaccination). The Western Pacific Region sets a goal to reduce hepatitis B infection among children to less than 1% with a milestone of less than 2% by 2012.

All countries and areas in the Region adopt hepatitis B birth dose vaccination for all newborn infants with the exception of Japan and New Zealand, which conduct targeted vaccination.

100% 1%100%

2

PartnersGlobal action or recommendation

Regional action or recommendations

Country or regional progress

Key MilestonesHepatitis B (HB)

HB fact

Plasma-derived hepatitis B vaccine becomes the first ever cancer preventing vaccine licensed (the recombinant hepatitis B vaccine in use today was licensed in 1986).

AusAID, NZAID, WHO and UNICEF implement a project to increase hepatitis B vaccination in Pacific island countries.

GAVI support for hepatitis B vaccine introduction becomes available for GAVI-eligible countries.

WHO recommends hepatitis B birth dose vaccination for all newborn infants.

Hong Kong (China) and Malaysia verified as having reached the 1% hepatitis B control goal. Tonga verified as having reached the 2% hepatitis B control milestone.

2%

The Western Pacific Region as a whole and at least 30 countries and areas meet the 2% hepatitis B milestone.

Australia, China, Mongolia and New Zealand verified as having reached the 1% hepatitis B control goal.

The Western Pacific Region holds discussions on setting the target year for the 1% goal.

Palau verified as having reached the 1% hepatitis B control goal.

The Victorian Infectious Diseases Reference Laboratory (VIDRL) becomes the hepatitis B reference laboratory for the Western Pacific Region.

CDC supports WHO Regional Office for the Western Pacific in hepatitis B control.

The World Health Organization recommends hepatitis B vaccination for all infants.

Macao (China) and the Republic of Korea and are the first countries and areas officially verified as having reached the 1% hepatitis B control goal.

100%

All countries and areas in the Region include hepatitis B vaccination as part of their national immunization policies (Japan has targeted vaccination). The Western Pacific Region sets a goal to reduce hepatitis B infection among children to less than 1% with a milestone of less than 2% by 2012.

All countries and areas in the Region adopt hepatitis B birth dose vaccination for all newborn infants with the exception of Japan and New Zealand, which conduct targeted vaccination.

100% 1%100%

3

Regional ProgressChronic Hepatitis B Virus (HBV) Prevalence in Children


The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimination of its fronteriers and boundaries. Dotted lines on maps represents approximate border lines for which there may not yet be full agreement © WHO Regional Office for the Western Pacific 2009. All rights reserved.

Chronic HBV prevalence before vaccine >6% prevalence

>2% - 6% prevalence

<2% prevalence

Chronic HBV prevalence in 2012 >6% prevalence

>2% - 6% prevalence

<2% prevalence


Mongolia

China Japan

Republic of Korea

Lao People’sDemocratic

Republic

Hong Kong (China)

Cambodia

SingaporeMalaysia

Viet Nam

Macao (China)

Australia

Commonwealth of Northern Mariana

Islands

MarshallIslands

Federated States of Micronesia

Philippines

Guam

BruneiDarussalam

Palau

PapuaNew Guinea

NauruKiribati

Vanuatu

New Zealand

SolomonIslands

NewCaledonia

Wallis and Futuna

Tuvalu

Tonga

Cook Islands

Fiji

Tokelau

American Samoa

French Polynesia

Niue

Samoa

Mongolia

China Japan

Republic of Korea


Republic

Hong Kong (China)

Cambodia

SingaporeMalaysia

Viet Nam

Macao (China)

Australia


Islands

MarshallIslands


Philippines

Guam

BruneiDarussalam

Palau

PapuaNew Guinea

NauruKiribati

Vanuatu

New Zealand

SolomonIslands

NewCaledonia

Wallis and Futuna

Tuvalu

Tonga

Cook Islands

Fiji

Tokelau

American Samoa

French Polynesia

Niue

Samoa

4




Chronic HBV prevalence before vaccine >6% prevalence

>2% - 6% prevalence

<2% prevalence

Chronic HBV prevalence in 2012 >6% prevalence

>2% - 6% prevalence

<2% prevalence


Mongolia

China Japan

Republic of Korea


Republic

Hong Kong (China)

Cambodia

SingaporeMalaysia

Viet Nam

Macao (China)

Australia


Islands

MarshallIslands


Philippines

Guam

BruneiDarussalam

Palau

PapuaNew Guinea

NauruKiribati

Vanuatu

New Zealand

SolomonIslands

NewCaledonia

Wallis and Futuna

Tuvalu

Tonga

Cook Islands

Fiji

Tokelau

American Samoa

French Polynesia

Niue

Samoa

Mongolia

China Japan

Republic of Korea


Republic

Hong Kong (China)

Cambodia

SingaporeMalaysia

Viet Nam

Macao (China)

Australia


Islands

MarshallIslands


Philippines

Guam

BruneiDarussalam

Palau

PapuaNew Guinea

NauruKiribati

Vanuatu

New Zealand

SolomonIslands

NewCaledonia

Wallis and Futuna

Tuvalu

Tonga

Cook Islands

Fiji

Tokelau

American Samoa

French Polynesia

Niue

Samoa

5

Regional ProgressHepatitis B Vaccination Coverage, 1990–2011

% V

acci

natio

n co

vera

ge

6

Verified to reach the milestone

Likely to have reached the regional milestone

Lack prevalence or immunization evidence suggesting milestone has been met

*Milestone: <2% childhood hepatitis B infection prevalance

Mongolia

China Japan

Republic of Korea


Republic

Cambodia

Singapore

Malaysia

Viet Nam

Macao (China)

Australia


Islands

MarshallIslands


Philippines

Guam

BruneiDarussalam

Palau

PapuaNew Guinea

NauruKiribati

Vanuatu

New Zealand

SolomonIslands

NewCaledonia

Wallis and Futuna

Tuvalu

Tonga

Cook Islands

Fiji

Tokelau

American Samoa

French Polynesia

Niue

Samoa

Hong Kong (China)

Regional ProgressStatus of the 2012 Hepatitis B Control Milestone*


7

Health facility

Home with SBA

Home with no SBA

Unknown

99.0%

1.0%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008

Timely HepB BD HepB3 Any HepB BD

(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%

Abbreviations: DTP3: 3rd dose of Diphteria, Tetanus, and Pertussis Vaccine; HepB3: at least 3 doses of hepatitis B vaccine; HBsAg: hepatitis B surface antigen; SBA: Skilled Birth Attendant; Timely HepB BD: birth dose within 24 hours Sources: UN, UNICEF and WHO* HepB3 vaccination coverage when available, otherwise graph represents DPT3 coverage.

DemographicsAMERICAN SAMOA

Hepatitis B vaccine

Total population (2012) 70 680Births (2012) 1375Surviving infants (2012) 1359Urban population (2012) 93%

HepB3 introduced nationwide 1986–1987HepB birth dose introduced not reportedCurrent schedule 0, 1 month, 12 monthsHepB3 type Monovalent

Neonatal deliveries Reported hepatitis B vaccination coverage Districts by coverage categories*

Vaccination coverage surveys

Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 1990 National 3–4 years 95 not reported 82% not reported Mahoney Pac Hth Dialog 19961995 National 7–8 years 432 75% 91% not reported Bialek ISVHLD P351 20061996 National 7–8 years 435 not reported 87% not reported Mahoney Pac Hth Dialog 1996

Hepatitis B serological surveys

Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 1991 T utuila 3–4 years Community based 93 2.2% Mahoney JID 20091995 Nationwide 7–8 years Community based 432 0.5% Bialek ISVHLD P351 20062011 Nationwide 6 years School based 562 0.20% PRELIMINARY DATA

WHO verification

Status of verifying prevalence targets

Verification started: pendingDecision: n.a.Decision date: n.a.

8

Health facility

Home with SBA

Home with no SBA

Unknown

99.10%

0.90%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics AUSTRALIAHepatitis B vaccine

Total population (2012) 22 918 688Births (2012) 310 837Surviving infants (2012) 305 841Urban population (2012) 89%

HepB3 introduced nationwide 2000HepB birth dose introduced 2000Current schedule 0, 2 months, 4 months, 6 monthsHepB3 type DTP-Hib-HepB-IPV



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2007 National 12 months 280874 not reported 94% 92% From National Health Insurance covering 99% of population


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 2002 Nationwide 1–9 years Hospital based 249 0.4% (0.0% – 2.2%) Gidding Vaccine 2007

WHO verification


Verification started: June 2012Decision: <1% in childrenDecision date: December 2012

9

Health facility

Home with SBA

Home with no SBA

Unknown

99.80%

0.10%0.10%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsBRUNEI DARUSSALAM

Hepatitis B vaccine


HepB3 introduced nationwide 1988HepB birth dose introduced 1988Current schedule 0, 2 months, 4 months, 6 monthsHepB3 type DTP-Hib-HepB-IPV



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % %


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 2011 National 8–9 years School based 4513 not reported MoH 2011 prelim data

WHO verification


Verification started: December 2012Decision: 1%Decision date: June 2013

10

Health facility

Home with SBA

Home with no SBA

Unknown

54.0%

17.0%

29.0%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics CAMBODIAHepatitis B vaccine


HepB3 introduced nationwide 2005HepB birth dose introduced 2005Current schedule 0, 6 weeks, 10 weeks,14 weeksHepB3 type DTP-Hib-HepB



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2005 National 12–24 months 1517 not reported not reported 78% DHS Survey2010 National 12–24 months 1614 73% 84% not reported DHS Survey: birth dose by 12M


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 2001 Kg Chhnang 9–17 months Hospital based 900 2.7% Report MoH/PATH/AIHI2006 Nationwide 5 years Community based 1558 3.5% (2.4% – 4.8%) Soeung AMTH 20092011 Urban, Rural, Remote 4–5 years Community based 2429 0.3%, 1.4%, 3.4% PRELIMINARY DATA

WHO verification



11

Health facility

Home with SBA

Home with no SBA

Unknown

96.30%

3.70%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsCHINA Hepatitis B vaccine

Total population (2012) 1 353 600 687Births (2012) 16 209 546Surviving infants (2012) 16 068 111Urban population (2012) 50%

HepB3 introduced nationwide 1992HepB birth dose introduced 1992Current schedule 0, 1 months, 6 monthsHepB3 type Monovalent



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2006 National 1 year 3636 93% 83% not reported Liang JID 2009; 2005 birth cohort


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 2006 Nationwide 1–4 years Community based 16376 1.0% (0.8% – 1.2%) Liang Vaccine 20092006 Nationwide 5 years Community based 2215 1.1% (0.4% – 1.8%) Liang JID 20092006 Nationwide 6 years Community based 2356 0.9% (0.4% – 1.5%) Liang JID 2009

WHO verification


Verification started: February 2012Decision: <1% in childrenDecision date: June 2012

12

Health facility

Home with SBA

Home with no SBA

Unknown

100.0%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics HONG KONG (CHINA)

Hepatitis B vaccine





Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2009 National 2–5 years 6248 not reported ≥99.5% >99.8% MoH HOK 2011


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 2006 Nationwide 1–4 years Laboratory based 196 1% MoH HOK 20112009 Nationwide 12–15 years School based 1913 0.8% (0.4% – 1.2%) MoH HOK 2011

WHO verification


Verification started: February 2011Decision: <1% in childrenDecision date: July 2011

13

Health facility

Home with SBA

Home with no SBA

Unknown

100.0%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsMACAO (CHINA) Hepatitis B vaccine







Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 2003 Nationwide 6–9 years School based 437 0% (0% – 0.7%) MoH MAC 2008

WHO verification


Verification started: April 2008Decision: <1% in childrenDecision date: August 2008

14

Health facility

Home with SBA

Home with no SBA

Unknown

99.60%

0.40%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics COOK ISLANDSHepatitis B vaccine


HepB3 introduced nationwide 1989HepB birth dose introduced n.a.Current schedule 0, 6 weeks, 3 months, 5 monthsHepB3 type DTP-Hib-HepB





Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 2012 7 of 11 islands 6 years School based 265 0% PRELIMINARY DATA

WHO verification


Verification started: October 2011Decision: n.a.Decision date: n.a.

15

Health facility

Home with SBA

Home with no SBA

Unknown

99.80%

0.20%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsFIJI Hepatitis B vaccine

Total Population (2012) 875 822Births (2012) 18 201Surviving infants (2012) 18 080Urban Population (2012) 52%




Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2008 not reported not reported 439 86% 99% not reported Confirm data with country


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 1998 Large T owns 12–24 months Hospital based 285 0.7% Wilson Vaccine 20002008 Sub-national 6 months–5 years Community based 428 0% WHO:RS/2009/GE/23(JPN)

WHO verification



16

Health facility

Home with SBA

Home with no SBA

Unknown

99.00%

1.00%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics FRENCH POLYNESIA

Hepatitis B vaccine

Total Population (2012) 276 731Births (2012) 4562Surviving infants (2012) 4543Urban Population (2012) 51%

HepB3 introduced nationwide 1992HepB birth dose introduced not reportedCurrent schedule 0, 1 months, 6 monthsHepB3 type Monovalent





Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 1988 Austral Island 0–11 months Community based 957 2.1% B Trans R Soc Trop 1990

WHO verification



17

Health facility

Home with SBA

Home with no SBA

Unknown

87.22%0.60%

12.20%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsGUAM Hepatitis B vaccine


HepB3 introduced nationwide 1988–1989HepB birth dose introduced not reportedCurrent schedule 0, 2 months, 4 months, 6 months, 12 monthsHepB3 type DTP-Hib-HepB





Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI)

WHO verification



18

Health facility

Home with SBA

Home with no SBA

Unknown

99.77%

0.18% 0.05%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics JAPANHepatitis B vaccine

Total Population (2012) 126 434 653Births (2012) 1 068 161Surviving infants (2012) 1 070 409Urban Population (2012) 67%

HepB3 introduced nationwide not reportedHepB birth dose introduced not reportedCurrent schedule if HBsAg+ motherHepB3 type Monovalent





Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 1989 Okinawa 1–4 years School based 1529 0.1% Hayashi Int J Epi 1990 1995–1996 Nationwide 16–19 years Blood Donors 107879 0.4% (0.4% – 0.5%) Furusyo AMTM 19981995–2000 Nationwide 16–19 years Blood Donors 582415 0.23% (0.22% – 0.24%) Tanaka Intervirol 2004

WHO verification



19

Health facility

Home with SBA

Home with no SBA

Unknown

81.85%16.40%

1.75%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsKIRIBATI Hepatitis B vaccine







Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 1998 Large Towns 12–24 months Hospital based 156 3.8% Wilson Vaccine 2000

WHO verification



20

Health facility

Home with SBA

Home with no SBA

Unknown

12.80%

5.70%

81.50%Va

ccin

atio

n co

vera

ge (%

)0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics LAO PEOPLE’S DEMOCRATIC

REPUBLIC

Hepatitis B vaccine

Total Population (2012) 6 373 934Births (2012) 139 845Surviving infants (2012) 135 845Urban Population (2012) 33%

HepB3 introduced nationwide 2001HepB birth dose introduced ~ 2005Current schedule 0, 6 weeks, 10 weeks,14 weeksHepB3 type DTP-Hib-HepB



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2006 National 12 months 828 not reported not reported 32% MICS; 41.3% HepB3 by 23M


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 2011 National 5–9 years Community based 1008 1.5% PRELIMINARY DATA

WHO verification



21

Health facility

Home with SBA

Home with no SBA

Unknown

98.12%

0.53% 1.35%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsMALAYSIA Hepatitis B vaccine


HepB3 introduced nationwide 1989HepB birth dose introduced 1989 Current schedule 0, 1 months, 6 monthsHepB3 type Monovalent





Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 1997–2007 Nationwide 6–9 years School based 193717 0.4% MoH Malaysia 20112009 Nationwide 9 years School based 2938 0.2% (0% – 0.3%) MoH Malaysia 20112009 Nationwide 10 years School based 3265 0.4% (0.2% – 0.6%) MoH Malaysia 2011

WHO verification


Verification started: March 2011Decision: <1% in childrenDecision date: July 2011

22

Health facility

Home with SBA

Home with no SBA

Unknown

97.00%

2.00% 1.00%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics MARSHALL ISLANDS

Hepatitis B vaccine


HepB3 introduced nationwide 1990sHepB birth dose introduced 1998Current schedule 0, 2 months, 4 months, 6 monthsHepB3 type DTP-HepB-IPV



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2007 Majuro, Ebeye 5–9 years 331 49% 93% not reported Bialek Ped Infect Dis 2010


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 2007 Majuro, Ebeye 5–9 years School based 331 1.8% (0.4% – 3.3%) Bialek PID 2010

WHO verification



23

Health facility

Home with SBA

Home with no SBA

Unknown

80.00%20.00%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsFEDERATED STATES OF MICRONESIA

Hepatitis B vaccine


HepB3 introduced nationwide not reportedHepB birth dose introduced not reportedCurrent schedule 0, 2 months, 6 monthsHepB3 type Monovalent



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 1989 National 2 years 16391 not reported 84% not reported Manea PH Reports 19921992 Chuuk 2 years 544 not reported 40% not reported Mahoney Pac Hth Dialog 19961994 Pohnpei 3–4 years 364 not reported 82% not reported Mahoney Pac Hth Dialog 1996


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 2005 Chuuk 2–6 years Hospital based 362 2.5% Bialek PID 2010

WHO verification



24

Health facility

Home with SBA

Home with no SBA

Unknown

99.51%

0.20%0.20%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics MONGOLIAHepatitis B vaccine


HepB3 introduced nationwide 1991HepB birth dose introduced not reportedCurrent schedule 0, 2 months, 3 months, 4 monthsHepB3 type DTP-Hib-HepB



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 1999 Urban Area 2 years 127 not reported 94% not reported Edstam Prev Med 20021999 Rural 2 years 148 not reported 76% not reported Edstam Prev Med 20022004 National 8 years 1145 65% 60% not reported Davaalkham J Epid 2007


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 2004 Nationwide 7–12 years School based 1145 5.2% Davaalkham PI 20072009 Nationwide 4 years Community based 5894 0.34% MoH Mongolia 2011

WHO verification


Verification started: April 2012Decision: <1% in childrenDecision date: July 2012

25

Health facility

Home with SBA

Home with no SBA

Unknown

97.40%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsNAURU Hepatitis B vaccine


HepB3 introduced nationwide 1983HepB birth dose introduced not reportedCurrent schedule 0, 6 weeks, 10 weeks,14 weeksHepB3 type DTP-Hib-HepB






WHO verification



26

Health facility

Home with SBA

Home with no SBA

Unknown

87.60%4.37%8.03%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics NEW CALEDONIAHepatitis B vaccine


HepB3 introduced nationwide 1989HepB birth dose introduced 1998 (for HBsAg+ moms)Current schedule 0, 1 months, 6 monthsHepB3 type Monovalent






WHO verification



27

Health facility

Home with SBA

Home with no SBA

Unknown

95.30%

4.70%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsNEW ZEALAND Hepatitis B vaccine


HepB3 introduced nationwide 1985HepB birth dose introduced not reportedCurrent schedule 6 weeks, 3 months, 5 monthsHepB3 type DTP-Hib-HepB-IPV



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2005 National 12 months 1563 72% 82% 85% MoH; 87% HepB3 by 2Y


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 2009 North Islands 6 years Community based 466 0.2% (0.0% – 1.2%) Weir R. MoH NEZ 2009

WHO verification


Verification started: April 2012Decision: <1% in childrenDecision date: September 2012

28

Health facility

Home with SBA

Home with no SBA

Unknown

100.0%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics NIUEHepatitis B vaccine

Total Population (2012) 1385Births (2012) 25Surviving infants (2012) 25Urban Population (2012) 38%

HepB3 introduced nationwide not reportedHepB birth dose introduced not reportedCurrent schedule 0, 6 weeks, 3 months, 5 monthsHepB3 type DTP-Hib-HepB-IPV






WHO verification



29

Health facility

Home with SBA

Home with no SBA

Unknown

100.0%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsNORTHERN MARIANA ISLANDS

Hepatitis B vaccine


HepB3 introduced nationwide 1988HepB birth dose introduced 1988Current schedule 0, 6 weeks, 6 monthsHepB3 type DTP-HepB-IPV



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 1995 National 3–4 years 200 not reported 94% not reported Mahoney Pac Hth Dialog 19962005 National 19–35 months 295 100% 94% not reported not reported


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 1994 Saipan 3–4 years Health facility 200 0.5% Durand Pac Hlth Dial 1996

WHO verification



30

Health facility

Home with SBA

Home with no SBA

Unknown

100.0%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics PALAUHepatitis B vaccine


HepB3 introduced nationwide 1989HepB birth dose introduced 1989Current schedule 0, 6 weeks, 4 months, 6 monthsHepB3 type DTP-HepB-IPV



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2003 National 10–11 years 192 100% 85% not reported Bialek ISVHLD P351 2006


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 2003 Nationwide 10–11 years Community based 192 0% Bialek ISVHLD P351 2006

WHO verification


Verification started: January 2013Decision: <1% in childrenDecision date: May 2013

31

Health facility

Home with SBA

Home with no SBA

Unknown

40.00%60.00%

Vacc

inat

ion

Cov

erag

e (%

)0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsPAPUA NEW GUINEA

Hepatitis B vaccine


HepB3 introduced nationwide 1989HepB birth dose introduced ~ 2005Current schedule 0, 1 months, 2 months, 3 monthsHepB3 type DTP-Hib-HepB





Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 1989–1990 Port Moresby 3–5 months Hospital based 31 13% Nemba A TPaed. 1993

WHO verification



32

33

Health facility

Home with SBA

Home with no SBA

Unknown

44.0%

18.20%

37.80%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics PHILIPPINESHepatitis B vaccine


HepB3 introduced nationwide 1991HepB birth dose introduced 2007Current schedule 0, 6 weeks, 10 weeks, 14 weeksHepB3 type DTP-Hib-HepB



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2003 National 12–24 months 1348 not reported NR 79 DHS Survey 2008 National 12–24 months 1286 not reported 80.3 NR DHS Survey



WHO verification



34

Health facility

Home with SBA

Home with no SBA

Unknown

99.90%

0.10%

Vacc

inat

ion

Cov

erag

e (%

)0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsREPUBLIC OF KOREA

Hepatitis B vaccine


HepB3 introduced nationwide 1983HepB birth dose introduced 1983Current schedule 0, 1 month, 6 monthsHepB3 type Monovalent



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2008 National 0–6 years 1026 100% 93% 94.7% CDC Korea; provided during 2012 TAG2011 National 0–3 years 7040 99% 98% 93.4% CDC Korea; provided during 2012 TAG


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 2005 Nationwide 10–14 years Community based 594 0.2% (0.0% – 0.6%) CDC Korea 20082007 Nationwide 4–6 years Hospital based 2920 0.2% (0.0% – 0.4%) CDC Korea 2008

WHO verification


Verification started: January 2008Decision: <1% in childrenDecision date: June 2008

Health facility

Home with SBA

Home with no SBA

Unknown

81.00%19.00%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics SAMOAHepatitis B vaccine





Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2009 National 12–24 months 321 70% not reported not reported DHS Survey



WHO verification



35

Health facility

Home with SBA

Home with no SBA

Unknown

99.74%

0.26%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsSINGAPORE Hepatitis B vaccine





Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2007 National 2 years 31778 not reported 94–96% 97% NR


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 1998–1999 National 0–4 years not reported 229 0% Epi News Bull SNG 2000

WHO verification



36

Health facility

Home with SBA

Home with no SBA

Unknown

85.00%1.00%

14.00%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics SOLOMON ISLANDS

Hepatitis B vaccine

Total Population (2012) 566 481Births (2012) 17 414Surviving infants (2012) 16 761Urban Population (2012) 19%






Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 1999 Guadalcanal Islands 0–9 years Hospital based 115 13% Furusyo Am J Trop 1999

WHO verification



37

Health facility

Home with SBA

Home with no SBA

Unknown

100.0%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsTOKELAU Hepatitis B vaccine


HepB3 introduced nationwide not reportedHepB birth dose introduced not reportedCurrent schedule 0, 6 weeks, 10 weeks,14 weeksHepB3 type DTP-Hib-HepB






WHO verification



38

Health facility

Home with SBA

Home with no SBA

Unknown

98.00%

0.40% 1.60%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics TONGAHepatitis B vaccine


HepB3 introduced nationwide 1989HepB birth dose introduced not reportedCurrent schedule 0, 6 weeks, 10 weeks,14 weeksHepB3 type DTP-Hib-HepB



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2005 Tongatapu hospital 6–59 months 445 92% 98% 98% Danielsson Vaccine 2009


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 1998 Large T owns 12–24 months Hospital based 211 3.8% Wilson Vaccine 20002005 Main Island 6–59 months Hospital based 375 0.8% (0.2% – 2.5%) Danielsson Vaccine 2009

WHO verification


Verification started: May 2011Decision: <2% in childrenDecision date: January 2012

39

Health facility

Home with SBA

Home with no SBA

Unknown

100.0%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


DemographicsTUVALU Hepatitis B vaccine


HepB3 introduced nationwide not reportedHepB birth dose introduced not reportedCurrent schedule 0, 6 weeks, 10 weeks, 14 weeksHepB3 type DTP-Hib-HepB





Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 1976 Fanafuti 10–19 years Community based 181 11% Gust JID 1979

WHO verification



40

Health facility

Home with SBA

Home with no SBA

Unknown

80.0%20.0%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics VANUATUHepatitis B vaccine


HepB3 introduced nationwide 1989–1990HepB birth dose introduced 1989–1990Current schedule 0, 6 weeks, 10 weeks, 14 weeksHepB3 type DTP-Hib-HepB



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2007 National 13 months 359 not reported 59% 58% MICS; 55.3% HepB3 by 23M


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 1998 Large T owns 12–24 months Hospital based 132 3.0% Wilson Vaccine 20001988 Emao or Nguna 12–18 months Community based 112 17% Maher Med J Aust 1991

WHO verification



41

Health facility

Home with SBA

Home with no SBA

Unknown

94.40%

5.60%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


VIET NAM Demographics Hepatitis B vaccine


HepB3 introduced nationwide 1997HepB birth dose introduced 2005Current schedule 0, 2 months, 3 months, 4 monthsHepB3 type DTP-Hib-HepB



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2002 National 12–24 months 457 not reported not reported 72% DHS Survey2006 National 12 months 555 not reported 32% 76% MICS; 33.9% HepB3 by 23M


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 1998 Thanh Hoa 9–18 months Community based 536 12.5% Hipgrave AJTMH 20032011 National 3–4 years Community based 3426 1.6% PRELIMINARY DATA2011 National 5–7 years Community based 1738 2.10% PRELIMINARY DATA

WHO verification



42

Health facility

Home with SBA

Home with no SBA

Unknown

100.0%

Vacc

inat

ion

cove

rage

(%)

0

20

40

60

80

100

20122011201020092008


(%) D

istr

icts

201

2

0

20

40

60

80

100

Timely HepB BDHepB3

>94%90%–94%80%–89%50%–79%<50%


Demographics WALLIS AND FUTUNA

Hepatitis B vaccine


HepB3 introduced nationwide not reportedHepB birth dose introduced not reportedCurrent schedule 0, 2 months, 3 months, 4 months, 16 monthsHepB3 type DTP-HepB-IPV



Survey Location Ages Sample HepB BD HepB3 DTP3 Reference/Notes year enrolled size % % % 2011 National 7–12 years 442 not reported 94% not reported Data from national serosurvey


Survey Location Ages Sampling Sample HBsAG prevalence Reference/Notes year enrolled base size (95% CI) 2012 National 7–12 years School-based 469 0.4% (0% – 1.0%) PRELIMINARY DATA

WHO verification



43

Expanded Programme on Immunization Regional Office for the Western Pacific World Health Organization P.O. Box 2932, 1000 Manila, Philippines Tel. no. (+63 2) 5288001 Fax no. (+63 2) 5211036, 5260279 [email protected]

Hepatitis B Control - wpro.who.int · hepatitis B control. The World Health Organization recommends...

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Transcript of Hepatitis B Control - wpro.who.int · hepatitis B control. The World Health Organization recommends...