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The impact of the timely birth dose vaccine on the global elimination of hepatitis B

ABSTRACT: In 2016 the World Health Organization set the goal of eliminating hepatitis B globally by 2030. Horizontal transmission has been greatly reduced in most countries by scaling up coverage of the infant HBV vaccine series, and vertical transmission is therefore becoming increasingly dominant. Here we show that scaling up timely hepatitis B birth dose vaccination to 90% of new-borns in 110 low- and middle-income countries by 2030 could prevent 710,000 (580,000 to 890,000) deaths in the 2020 to 2030 birth cohorts compared to status quo, with the greatest benefits in Africa. Maintaining this could lead to elimination by 2030 in the Americas, but not before 2059 in Africa. Drops in coverage due to disruptions in 2020 may lead to 15,000 additional deaths, mostly in South-East Asia and the Western Pacific. Delays in planned scale-up could lead to an additional 580,000 deaths globally in the 2020 to 2030 birth cohorts. The timely hepatitis B birth dose vaccination is recommended for all new-borns by the WHO, but coverage is inconsistent. Here, the authors model the impact of scaling-up coverage in 110 low and middle income countries and assess how it may be affected by delays for example caused by the COVID-19 pandemic.

SUBMITTER: de Villiers M

PROVIDER: S-EPMC8553835 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Modelling hepatitis B virus infection and impact of timely birth dose vaccine: A comparison of two simulation models.

Project description:Hepatitis B is a global epidemic that requires carefully orchestrated vaccination initiatives in geographical regions of medium to high endemicity to reach the World Health Organization's elimination targets by 2030. This study compares two widely-used deterministic hepatitis B models-the Imperial HBV model and the CDA Foundation's PRoGReSs-based on their predicted outcomes in four countries. The impact of scaling up of the timely birth dose of the hepatitis B vaccine is also investigated. The two models predicted largely similar outcomes for the impact of vaccination programmes on the projected numbers of new cases and deaths under high levels of the infant hepatitis B vaccine series. However, scenarios for the scaling up of the infant hepatitis B vaccine series had a larger impact in the PRoGReSs model than in the Imperial model due to the infant vaccine series directly leading to the reduction of perinatal transmission in the PRoGReSs model, but not in the Imperial model. Meanwhile, scaling up of the timely birth dose vaccine had a greater impact on the outcomes of the Imperial hepatitis B model than in the PRoGReSs model due to the greater protection that the birth dose vaccine confers to infants in the Imperial model compared to the PRoGReSs model. These differences underlie the differences in projections made by the models under some circumstances. Both sets of assumptions are consistent with available data and reveal a structural uncertainty that was not apparent in either model in isolation. Those relying on projections from models should consider outputs from both models and this analysis provides further evidence of the benefits of systematic model comparison for enhancing modelling analyses.

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Hepatitis B Birth Dose: First Shot at Timely Early Childhood Vaccination.

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Determinants of timely administration of the birth dose of hepatitis B vaccine in Senegal in 2019: Secondary analysis of the demographic and health survey.

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Project description: Not available

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Barriers to timely administration of birth dose vaccines in The Gambia, West Africa.

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Project description:In sub-Saharan Africa (SSA), chronic viral hepatitis B (HBV) affects more than 60 million people. Mother-to-child transmission is a major contributor to the ongoing HBV epidemic and yet only 11 of 54 (20.3%) SSA countries have introduced the birth dose of HBV vaccine (HepB-BD) into their regular immunization schedule. As more African countries adopt HepB-BD, implementation approaches must be targeted to ensure effective and timely HepB-BD delivery, especially in rural and under-resourced settings. We conducted a systematic literature review of published literature using PubMed. We included 39 articles published from January 2010 to August 2020, as well as gray literature, case studies, and research performed in SSA. We describe barriers to the uptake of HepB-BD in SSA at the policy, facility, and community levels and propose solutions that are relevant to stakeholders wishing to introduce HepB-BD. We highlight the importance and challenge of reaching infants who are born outside of health care facilities (i.e., home deliveries) with HepB-BD in partnership with community health workers. We also discuss the critical role of maternal education and community engagement in future HepB-BD scale-up efforts in SSA.

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