Effectiveness of the Targeted Hepatitis B Vaccination Program in Greenland

[Guest guest]

http://ajph.aphapublications.org/cgi/content/abstract/AJPH.2011.300239v2

AJPH First Look, published online ahead of print Sep 22, 2011

©This Article

 

American Journal of Public Health, 10.2105/AJPH.2011.300239

Effectiveness of the Targeted Hepatitis B Vaccination Program in Greenland

Malene L. Børresen, MD, PhD1, Anders Koch, MD, PHD, MPH2, J. Biggar, MD3,

Karin Ladefoged, MD, DMSc4, Mads Melbye, MD, DMSc5, Jan Wohlfahrt, MSc, DMSc6

and Tyra Grove Krause, M.D, PH.D7

1 Statens Serum Institut

2 Statens Serum Institut

3 Statens Serum Institut, Copenhagen

4 Queen Ingrid's Hospital

5 Statens Serum Institut, Copenhagen

6 Statens Serum Institut

7 Statens Serum Institute

Correspondence: tgv@...

Objectives. To evaluate the effectiveness of the hepatitis B virus (HBV)

vaccination program in Greenland, which targets children born to mothers who are

positive for HBV surface antigen (HBsAg), we determined vaccination coverage,

levels of postvaccination antibodies, and frequency of breakthrough infections

in at-risk children.

Methods. We conducted a population-based retrospective cohort study with data

from nationwide registries. We identified all children born to HBsAg positive

mothers from 1992 to 2007 and collected data on their HBV vaccination status. In

2008 to 2010, we tested the children for HBV core antibody, HBsAg, and

anti-HBsAg antibody (HBsAb).

Results. Of 4050 pregnant women, 3.2% were HBsAg positive. Of 207 children born

to these women, 20% received no vaccinations, and only 58% received at least 3

vaccinations. At follow-up, HBsAb levels in vaccinated children were much lower

than expected, and 8 (6%) of 140 at-risk children had breakthrough infections,

with 4 chronically infected (persistently HBsAg positive).

Conclusions. The prevention program targeting children at risk for HBV in

Greenland is ineffective. HBV vaccination should be included in the universal

childhood vaccination program, and postvaccination HBsAb levels should be

monitored. (Am J Public Health. Published online ahead of print September 22,

2011: e1-e8. doi:10.2105/AJPH.2011.300239)

[Guest guest]

http://ajph.aphapublications.org/cgi/content/abstract/AJPH.2011.300239v2

AJPH First Look, published online ahead of print Sep 22, 2011

©This Article

 

American Journal of Public Health, 10.2105/AJPH.2011.300239

Effectiveness of the Targeted Hepatitis B Vaccination Program in Greenland

Malene L. Børresen, MD, PhD1, Anders Koch, MD, PHD, MPH2, J. Biggar, MD3,

Karin Ladefoged, MD, DMSc4, Mads Melbye, MD, DMSc5, Jan Wohlfahrt, MSc, DMSc6

and Tyra Grove Krause, M.D, PH.D7

1 Statens Serum Institut

2 Statens Serum Institut

3 Statens Serum Institut, Copenhagen

4 Queen Ingrid's Hospital

5 Statens Serum Institut, Copenhagen

6 Statens Serum Institut

7 Statens Serum Institute

Correspondence: tgv@...

Objectives. To evaluate the effectiveness of the hepatitis B virus (HBV)

vaccination program in Greenland, which targets children born to mothers who are

positive for HBV surface antigen (HBsAg), we determined vaccination coverage,

levels of postvaccination antibodies, and frequency of breakthrough infections

in at-risk children.

Methods. We conducted a population-based retrospective cohort study with data

from nationwide registries. We identified all children born to HBsAg positive

mothers from 1992 to 2007 and collected data on their HBV vaccination status. In

2008 to 2010, we tested the children for HBV core antibody, HBsAg, and

anti-HBsAg antibody (HBsAb).

Results. Of 4050 pregnant women, 3.2% were HBsAg positive. Of 207 children born

to these women, 20% received no vaccinations, and only 58% received at least 3

vaccinations. At follow-up, HBsAb levels in vaccinated children were much lower

than expected, and 8 (6%) of 140 at-risk children had breakthrough infections,

with 4 chronically infected (persistently HBsAg positive).

Conclusions. The prevention program targeting children at risk for HBV in

Greenland is ineffective. HBV vaccination should be included in the universal

childhood vaccination program, and postvaccination HBsAb levels should be

monitored. (Am J Public Health. Published online ahead of print September 22,

2011: e1-e8. doi:10.2105/AJPH.2011.300239)