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Vaccines
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Timely Administration of the Hepatitis B Birth Dose Vaccine
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Timely Administration of the Hepatitis B Birth Dose Vaccine

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Hepatitis Virus Vaccines".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 47373

Special Issue Editors

Dr. Yusuke Shimakawa

E-Mail Website
Guest Editor
Unité d’Epidémiologie des Maladies Emergentes, Institut Pasteur, 75015 Paris, France
Interests: viral hepatitis; epidemiology; prevention; Africa
Dr. Youkyung Choi

E-Mail Website
Co-Guest Editor
Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, The Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
Interests: hepatitis viruses (A, B, C, D, and E); experimental system; host immune responses; vaccines; pathogenesis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

To achieve the WHO’s objective to globally eliminate hepatitis B virus (HBV) infection by 2030, it is essential to prevent mother-to-child transmission of HBV. Administration of the hepatitis B vaccine to neonates, preferably within 24 hours after birth, is a key intervention recommended by the WHO to reach this goal. However, the timely administration of the hepatitis B birth dose vaccine (HepB-BD) has not been well implemented in low- and middle-income countries for multiple reasons, including a high rate of childbirth at home.

This Special Issue aims to uncover the current situation of the implementation of the HepB-BD, the challenges and facilitators for its timely administration, and potential innovations to overcome these problems. This Special Issue welcomes the submission of papers from a wide range of disciplines including basic science, clinical/epidemiological research, social/anthropological studies, and health economy.

Dr. Yusuke Shimakawa
Dr. Youkyung Choi
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Coverage for the hepatitis B birth dose vaccine
  • Cost-effectiveness of the hepatitis B birth dose vaccination
  • Potential innovations to reach babies born at home
  • Controlled temperature chain
  • Microneedle patch
  • Qualitative research
  • Health economy Implementation science vaccine
  • Birth dose
  • Mother-to-child transmission

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12 pages, 1350 KiB  
Communication
Timely Birth Dose Vaccine to Prevent Vertical Transmission of Hepatitis B: A Single Center Experience on the Road to the WHO Elimination Goals in Italy
by Michele Pinon, Laura Giugliano, Emanuele Nicastro, Omar Kakaa, Alessandra Coscia, Caterina Carbonara, Lorenzo D’Antiga and Pier Luigi Calvo
Vaccines 2021, 9(7), 801; https://doi.org/10.3390/vaccines9070801 - 19 Jul 2021
Cited by 2 | Viewed by 2627
Abstract
Italy was one of the first industrialized countries to implement a program of routine vaccination against hepatitis B virus (HBV) infection. However, currently, no HBV vaccine is administered at birth if the screened mother is HBsAg negative, whilst babies born to HBsAg positive [...] Read more.
Italy was one of the first industrialized countries to implement a program of routine vaccination against hepatitis B virus (HBV) infection. However, currently, no HBV vaccine is administered at birth if the screened mother is HBsAg negative, whilst babies born to HBsAg positive mothers are given vaccine and hepatitis B immunoglobulin, within 12–24 post-delivery hours. A single center retrospective analysis of policies and practices to prevent mother-to-child transmission of HBV was carried out, to evaluate their adherence to HBV care guidelines. Paired maternal-infant medical records for consecutive live births, between January 2015 and December 2019, were reviewed at the AOU Città della Salute e Scienza di Torino, where a total of 235/35,506 babies (0.7%) were born to HBsAg positive mothers. Markers of active viral replication, i.e., HBV DNA level and/or HBeAg, were reported in only 66/235 (28%) of the mothers’ medical records. All newborns had immunoprophylaxis at birth: 61% at <12 h, 31% between 12 and 24 h, 7% between 24 and 36 h and 1% at >36 h. In 2019, two cases of vertical HBV transmission occurred, despite timely immunoprophylaxis, as their mothers’ viral load was detected too late for antiviral prophylaxis. Missed early identification of pregnant women with high viremia levels or late vaccinations may contribute to perinatal HBV infection. Immunoprophylaxis should be given to babies born to HBsAg positive mothers at the latest within 12 h. In Italy, policies aimed at achieving the WHO 2030 goal of eliminating viral hepatitis should be further implemented. Full article
(This article belongs to the Special Issue Timely Administration of the Hepatitis B Birth Dose Vaccine)
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19 pages, 3376 KiB  
Article
Impact of Introducing Hepatitis B Birth Dose Vaccines into the Infant Immunization Program in Burkina Faso: Study Protocol for a Stepped Wedge Cluster Randomized Trial (NéoVac Study)
by Haoua Tall, Pierrick Adam, Abdoul Salam Eric Tiendrebeogo, Jeanne Perpétue Vincent, Laura Schaeffer, Cassandre von Platen, Sandrine Fernandes-Pellerin, François Sawadogo, Alkadri Bokoum, Ghislain Bouda, Seydou Ouattara, Issa Ouédraogo, Magali Herrant, Pauline Boucheron, Appolinaire Sawadogo, Edouard Betsem, Alima Essoh, Lassané Kabore, Amariane Ouattara, Nicolas Méda, Hervé Hien, Andréa Gosset, Tamara Giles-Vernick, Sylvie Boyer, Dramane Kania, Muriel Vray and Yusuke Shimakawaadd Show full author list remove Hide full author list
Vaccines 2021, 9(6), 583; https://doi.org/10.3390/vaccines9060583 - 1 Jun 2021
Cited by 6 | Viewed by 4242
Abstract
To achieve global hepatitis elimination by 2030, it is critical to prevent the mother-to-child transmission (MTCT) of hepatitis B virus (HBV). Since 2009, the WHO has recommended administering hepatitis B vaccine to all neonates within 24 h of birth to prevent MTCT. However, [...] Read more.
To achieve global hepatitis elimination by 2030, it is critical to prevent the mother-to-child transmission (MTCT) of hepatitis B virus (HBV). Since 2009, the WHO has recommended administering hepatitis B vaccine to all neonates within 24 h of birth to prevent MTCT. However, many countries in sub-Saharan Africa only provide hepatitis B immunization at the age of 6, 10, and 14 weeks or 8, 12, and 16 weeks using a combined vaccine. To accelerate the introduction of the hepatitis B birth dose vaccine (HepB-BD) into sub-Saharan Africa, it is critical to establish to what extent the addition of HepB-BD can further reduce HBV transmission in areas where three-dose infant vaccination has been implemented. We therefore designed a study to evaluate the impact, acceptability, and cost-effectiveness of incorporating the HepB-BD into the routine immunization program in a real-life field condition in Burkina Faso, where the hepatitis B vaccination is currently scheduled at 8-12-16 weeks. Through a multidisciplinary approach combining epidemiology, anthropology, and health economics, the Neonatal Vaccination against Hepatitis B in Africa (NéoVac) study conducts a pragmatic stepped wedge cluster randomized controlled trial in rural areas of the Hauts-Bassins Region. The study was registered in ClinicalTrials.gov (identifier: NCT04029454). A health center is designated as a cluster, and the introduction of HepB-BD will be rolled out sequentially in 24 centers. Following an initial period in which no health center administers HepB-BD, one center will be randomly allocated to incorporate HepB-BD. Then, at a regular interval, another center will be randomized to cross from the control to the intervention period, until all 24 centers integrate HepB-BD. Pregnant women attending antenatal care will be systematically invited to participate. Infants born during the control period will follow the conventional immunization schedule (8-12-16 weeks), while those born in the interventional period will receive HepB-BD in addition to the routine vaccines (0-8-12-16 weeks). The primary outcome, the proportion of hepatitis B surface antigen (HBsAg) positivity in infants aged at 9 months, will be compared between children born before and after HepB-BD introduction. The study will generate data that may assist governments and stakeholders in sub-Saharan Africa to make evidence-based decisions about whether to add HepB-BD into the national immunization programs. Full article
(This article belongs to the Special Issue Timely Administration of the Hepatitis B Birth Dose Vaccine)
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16 pages, 606 KiB  
Article
The Costs of Introducing the Hepatitis B Birth Dose Vaccine into the National Immunization Programme in Senegal (NéoVac Study)
by Andréa Gosset, Marie Libérée Nishimwe, Mamadou Yaya Diallo, Lucas Deroo, Aldiouma Diallo, El Hadji Ba, Patrizia Maria Carrieri, Cheikh Sokhna, Muriel Vray, Yusuke Shimakawa and Sylvie Boyer
Vaccines 2021, 9(5), 521; https://doi.org/10.3390/vaccines9050521 - 18 May 2021
Cited by 3 | Viewed by 2880
Abstract
Some African countries are still reluctant to introduce the hepatitis B vaccine birth dose (HepB-BD) into their expanded program of immunization (EPI), partly because of logistical, economic, and cost information constraints. To assist decision-makers in these countries, we assessed the economic and financial [...] Read more.
Some African countries are still reluctant to introduce the hepatitis B vaccine birth dose (HepB-BD) into their expanded program of immunization (EPI), partly because of logistical, economic, and cost information constraints. To assist decision-makers in these countries, we assessed the economic and financial costs of HepB-BD introduction in Senegal in 2016. We performed a micro-costing study in a representative sample of Senegal’s EPI sites at all levels in 2018. Information on EPI and HepB-BD activity-related inputs and costs was collected using standardized questionnaires and semi-structured interviews. Using inverse probability weighting, we computed weighted average costs associated with HepB-BD introduction for each EPI level, country-level aggregated costs and estimated costs per newborn. Economic and financial costs from a government perspective were estimated in US dollars for 2015, 2016 and 2017. Total economic costs were USD 143,364 in 2015, USD 759,406 in 2016 and USD 867,311 in 2017, while financial costs were USD 127,745, USD 82,519 and USD 29,853, respectively. When annualizing pre-introduction and initial training costs, the economic (financial) cost per vaccinated newborn was USD 2.10 (USD 0.30) in 2016 and USD 1.90 (USD 0.20) in 2017. Our estimates provide valuable information to implement HepB-BD in Sub-Saharan African countries that have not yet integrated this vaccine. Full article
(This article belongs to the Special Issue Timely Administration of the Hepatitis B Birth Dose Vaccine)
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17 pages, 751 KiB  
Article
Hepatitis B Vaccination in Senegalese Children: Coverage, Timeliness, and Sociodemographic Determinants of Non-Adherence to Immunisation Schedules (ANRS 12356 AmBASS Survey)
by Lauren Périères, Fabienne Marcellin, Gora Lo, Camelia Protopopescu, El Hadji Ba, Marion Coste, Coumba Touré Kane, Gwenaëlle Maradan, Aldiouma Diallo, Cheikh Sokhna, Sylvie Boyer and on behalf of the ANRS 12356 AmBASS Survey Study Group
Vaccines 2021, 9(5), 510; https://doi.org/10.3390/vaccines9050510 - 15 May 2021
Cited by 10 | Viewed by 5307
Abstract
Detailed knowledge about hepatitis B virus (HBV) vaccination coverage and timeliness for sub-Saharan Africa is scarce. We used data from a community-based cross-sectional survey conducted in 2018–2019 in the area of Niakhar, Senegal, to estimate coverage, timeliness, and factors associated with non-adherence to [...] Read more.
Detailed knowledge about hepatitis B virus (HBV) vaccination coverage and timeliness for sub-Saharan Africa is scarce. We used data from a community-based cross-sectional survey conducted in 2018–2019 in the area of Niakhar, Senegal, to estimate coverage, timeliness, and factors associated with non-adherence to the World Health Organisation-recommended vaccination schedules in children born in 2016 (year of the birth dose (BD) introduction in Senegal) and 2017–2018. Vaccination status was assessed from vaccination cards, surveillance data, and healthcare post vaccination records. Among 241 children with available data, for 2016 and 2017–2018, respectively, 31.0% and 66.8% received the BD within 24 h of birth (BD schedule), and 24.3% and 53.7% received the BD plus at least two pentavalent vaccine doses within the recommended timeframes (three-dose schedule). In logistic regression models, home birth, dry season birth, and birth in 2016 were all associated with non-adherence to the recommended BD and three-dose schedules. Living over three kilometres from the nearest healthcare post, being the firstborn, and living in an agriculturally poorer household were only associated with non-adherence to the three-dose schedule. The substantial proportion of children not vaccinated according to recommended schedules highlights the importance of considering vaccination timeliness when evaluating vaccination programme effectiveness. Outreach vaccination activities and incentives to bring children born at home to healthcare facilities within 24 h of birth, must be strengthened to improve timely HBV vaccination. Full article
(This article belongs to the Special Issue Timely Administration of the Hepatitis B Birth Dose Vaccine)
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10 pages, 374 KiB  
Article
Mother-to-Child Transmission of Hepatitis B Virus in Ethiopia
by Asgeir Johannessen, Bitsatab Mekasha, Hailemichael Desalegn, Hanna Aberra, Kathrine Stene-Johansen and Nega Berhe
Vaccines 2021, 9(5), 430; https://doi.org/10.3390/vaccines9050430 - 26 Apr 2021
Cited by 10 | Viewed by 6557
Abstract
High viral load and positive hepatitis B e-antigen (HBeAg) results are risk factors for mother-to-child transmission (MTCT) of hepatitis B virus (HBV). In sub-Saharan Africa, little is known about the distribution of these risk factors, as well as early childhood HBV transmission. In [...] Read more.
High viral load and positive hepatitis B e-antigen (HBeAg) results are risk factors for mother-to-child transmission (MTCT) of hepatitis B virus (HBV). In sub-Saharan Africa, little is known about the distribution of these risk factors, as well as early childhood HBV transmission. In this study, Ethiopian women aged 18–45 years with chronic hepatitis B were assessed for the presence of HBeAg and high viral load. Their children below 4 years of age were invited for assessment of viral markers, defining active HBV infection as a positive hepatitis B s-antigen (HBsAg) and/or detectable HBV DNA. In total, 61 of 428 HBV-infected women (14.3%) had a positive HBeAg result and/or a high viral load. Of note, 26 of 49 women (53.1%) with viral load above 200,000 IU/mL were HBeAg negative. Among 89 children born of HBV-infected mothers (median age 20 months), 9 (10.1%) had evidence of active HBV infection. In conclusion, one in seven women with chronic hepatitis B had risk factors for MTCT, and HBeAg was a poor predictor of high viral load. One in ten children born of HBV-infected women acquired HBV-infection despite completing their scheduled HBV vaccination at 6, 10 and 14 weeks of age. Full article
(This article belongs to the Special Issue Timely Administration of the Hepatitis B Birth Dose Vaccine)
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14 pages, 1216 KiB  
Article
Efficacy of Birth Dose Vaccination in Preventing Mother-to-Child Transmission of Hepatitis B: A Randomized Controlled Trial Comparing Engerix-B and Sci-B-Vac
by Rifaat Safadi, Tawfik Khoury, Nizar Saed, Marwan Hakim, Jeryes Jamalia, Yousef Nijim, Nicola Farah, Tawfik Nuser, Nidaa Natur, Mahmud Mahamid, Johnny Amer, Pia L. Roppert, Wolfram H. Gerlich and Dieter Glebe
Vaccines 2021, 9(4), 331; https://doi.org/10.3390/vaccines9040331 - 1 Apr 2021
Cited by 10 | Viewed by 9632
Abstract
Background and aims: Peripartum transmission of hepatitis B virus (HBV) from an infected mother to the child can be prevented in most but not all cases by immediate vaccination of the newborn. The aim of this study was to compare the efficacy of [...] Read more.
Background and aims: Peripartum transmission of hepatitis B virus (HBV) from an infected mother to the child can be prevented in most but not all cases by immediate vaccination of the newborn. The aim of this study was to compare the efficacy of two licensed hepatitis B vaccines, Engerix-B versus Sci-B-Vac, in preventing peripartum HBV transmission. Methods: A prospective multicenter randomized controlled study in 4 delivery centers was performed from 2009 to 2014. HBsAg positive pregnant women and their newborns were recruited at the delivery rooms. All newborns received Hepatitis B Immune Globulin within 10 h after birth, as well as active HBV vaccination at 0, 1 and 6 months of age. Maternal assessment at delivery included transaminases, blood count, international normalized ratio and viral status. Infants were tested for HBsAg, anti-HBc and anti-HBs at 12 months of age. Results: In the intention to treat (ITT), 171 infant and mother pairs fulfilled the study enrollment criteria and completed follow up, 82 received Engerix-B and 89 Sci-B-Vac. Maternal parameters and viral status were similar in both groups. At 12 months of age, the Sci-B-Vac group had lower HBsAg carriage rates (1/89, 1.1%) than the Engerix-B group (5/82, 6.1%) with borderline significance (risk difference of −0.05, 95% CI −0.11–0.007, t-test = 0.05), and borderline significance lower vaccine failure rates with anti-HBs < 10 mIU/mL in the Sci-B-Vac (2/89, 2.2%) than in the Engerix-B (8/82, 9.8%, p = 0.05). Higher seroprotection rates were found in the Sci-B-Vac group with all anti-HBs titer stratifications of >10 mIU/mL (p = 0.05), >100 mIU/mL (p = 0.05) and >1000 mIU/mL (p = 0.01). Active/passive vaccination was effective in 10/13 cases with maternal HBV DNA levels > 7 log10 IU/mL up to 9.5 log10 IU/mL, but failed in 3 cases for unknown reasons. Conclusion: Sci-B-Vac was superior to Engerix-B in preventing peripartum HBV transmission in neonates from HBsAg+ mothers and induces significantly higher anti-HBs levels. NIH registration number: NCT 01133184. Full article
(This article belongs to the Special Issue Timely Administration of the Hepatitis B Birth Dose Vaccine)
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15 pages, 931 KiB  
Article
Coverage with Timely Administered Vaccination against Hepatitis B Virus and Its Influence on the Prevalence of HBV Infection in the Regions of Different Endemicity
by Karen K. Kyuregyan, Vera S. Kichatova, Olga V. Isaeva, Ilya A. Potemkin, Elena Yu. Malinnikova, Maria A. Lopatukhina, Anastasia A. Karlsen, Fedor A. Asadi Mobarhan, Eugeniy V. Mullin, Olga S. Slukinova, Margarita E. Ignateva, Snezhana S. Sleptsova, Elena E. Oglezneva, Elena V. Shibrik, Maria G. Isaguliants and Mikhail I. Mikhailov
Vaccines 2021, 9(2), 82; https://doi.org/10.3390/vaccines9020082 - 23 Jan 2021
Cited by 11 | Viewed by 3632
Abstract
Universal hepatitis B vaccination of newborns was implemented in Russia starting from 1998. From 1998 to 2019, the incidence of acute hepatitis B reduced from 43.8 to 0.57 cases per 100,000 population. Here, we assessed the timely coverage of newborns with the birth [...] Read more.
Universal hepatitis B vaccination of newborns was implemented in Russia starting from 1998. From 1998 to 2019, the incidence of acute hepatitis B reduced from 43.8 to 0.57 cases per 100,000 population. Here, we assessed the timely coverage of newborns with the birth dose (HepB-BD), second dose (HepB-2nd), and three vaccine doses (HepB3) in two remote regions of Russia with low (Belgorod Oblast) and high (Yakutia) levels of hepatitis B virus (HBV) endemicity. Vaccination data were obtained from the medical records of 1000 children in Yakutia and 2182 children in Belgorod Oblast. Sera of healthy volunteers from Belgorod Oblast (n = 1754) and Yakutia (n = 1072) across all age groups were tested for serological markers of HBV to assess the infection prevalence and herd immunity. Average HepB-BD coverage was 99.2% in Yakutia and 89.4% in Belgorod Oblast (p < 0.0001) and in both regions varied significantly, from 66% to 100%, between medical centers. The principal reason for the absence of HepB-BD was parent refusal, which accounted for 63.5% of cases of non-vaccination (83/123). While timely HepB-2nd coverage was only 55.4%–64.7%: HepB3 coverage by the age of one year exceeded 90% in both study regions. HBV surface antigen (HBsAg) prevalence in the 1998–2019 birth cohort was 0.2% (95% CI: 0.01–1.3%) in Belgorod Oblast and 3.2% (95% CI: 1.9–5.2%) in Yakutia. The proportion of persons testing negative for both antibodies to HBsAg (anti-HBs) and antibodies to HBV core antigen (anti-HBc) in the 1998–2019 birth cohort was 26.2% (125/481) in Belgorod Oblast and 32.3% (162/501) in Yakutia. We also assessed the knowledge of and attitude towards vaccination among 782 students and teachers of both medical and non-medical specialties from Belgorod State University. Only 60% of medical students knew that hepatitis B is a vaccine-preventable disease. Both medical and nonmedical students, 37.8% and 31.3%, respectively, expressed concerns about safety and actual necessity of vaccination. These data indicate the need to introduce a vaccine delivery audit system, improve medical education with respect to vaccination strategies and policies, and reinforce public knowledge on the benefits of vaccination. Full article
(This article belongs to the Special Issue Timely Administration of the Hepatitis B Birth Dose Vaccine)
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10 pages, 559 KiB  
Article
Comparison of Two Hepatitis B Vaccination Strategies Targeting Vertical Transmission: A 10-Year Japanese Multicenter Prospective Cohort Study
by Koji Nishimura, Keiji Yamana, Sachiyo Fukushima, Kazumichi Fujioka, Hiroshi Miyabayashi, Masao Murabayashi, Ken Masunaga, Aya Okahashi, Nobuhiko Nagano and Ichiro Morioka
Vaccines 2021, 9(1), 58; https://doi.org/10.3390/vaccines9010058 - 17 Jan 2021
Cited by 1 | Viewed by 3372
Abstract
In 1985, a hepatitis B (HB) vaccination strategy against vertical HB virus transmission was introduced in Japan that recommended vaccination of infants at two, three, and five months of age (delayed strategy). This schedule was revised in 2013, recommending to vaccinate at birth [...] Read more.
In 1985, a hepatitis B (HB) vaccination strategy against vertical HB virus transmission was introduced in Japan that recommended vaccination of infants at two, three, and five months of age (delayed strategy). This schedule was revised in 2013, recommending to vaccinate at birth and at 1 and 6 months of age (non-delayed strategy). We aimed to compare the vertical HB virus transmission rates and immunogenic responses between these two vaccination strategies. This Japanese multicenter prospective cohort study included 222 infants born between 2008 and 2017 to serum hepatitis B surface (HBs) antigen (HBsAg)-positive mothers. During the study period, 136 and 86 infants received delayed and non-delayed strategies, respectively. A positive vertical HB virus transmission was defined as a positive serum HBsAg status. Seropositive immunogenic response was defined as a serum anti-HBs titer of ≥10 mIU/mL. Post-vaccination serum HBsAg positivity rates did not differ significantly between the delayed (0/136 [0.0%, 95% confidence interval, 0.0–2.7%]) and non-delayed (2/86 [2.3%, 95% confidence interval, 0.3–8.1%]) strategy groups. Seropositive immunogenic response rates were 100.0% (136/136) and 97.7% (84/86), respectively. Although this study was under-powered to detect a statistically significant result, no vertical HB virus transmission was observed in the delayed strategy. Full article
(This article belongs to the Special Issue Timely Administration of the Hepatitis B Birth Dose Vaccine)
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16 pages, 1530 KiB  
Article
Coverage and Timeliness of Birth Dose Vaccination in Sub-Saharan Africa: A Systematic Review and Meta-Analysis
by Oumar Bassoum, Moe Kimura, Anta Tal Dia, Maud Lemoine and Yusuke Shimakawa
Vaccines 2020, 8(2), 301; https://doi.org/10.3390/vaccines8020301 - 11 Jun 2020
Cited by 18 | Viewed by 4650
Abstract
Background: Depending on the epidemiological context of each country, three vaccines are recommended by the World Health Organization (WHO) to be administered as soon as possible after birth (birth vaccines); namely, BCG, zero dose of oral polio vaccine (OPV0), and birth dose [...] Read more.
Background: Depending on the epidemiological context of each country, three vaccines are recommended by the World Health Organization (WHO) to be administered as soon as possible after birth (birth vaccines); namely, BCG, zero dose of oral polio vaccine (OPV0), and birth dose of hepatitis B vaccine (HepB-BD). The timely administration of these vaccines immediately after birth might pose significant challenges in sub-Saharan Africa, where about half of childbirths occur outside health facilities. We therefore conducted a systematic review and meta-analysis to estimate the coverage rate of these vaccines at a specific timing in neonates in sub-Saharan Africa. Methods: We searched PubMed, Embase, CINAHL, and Web of Science for studies conducted in sub-Saharan Africa and published up to March 31, 2017, which provided a coverage rate of the birth vaccines at any specific time points within 28 days after birth. Two investigators independently screened the titles and abstracts and extracted data from the eligible full-text articles. This study was registered in PROSPERO (CRD42017071269). Results: Of 7283 articles identified, we finally included 31 studies with 204,111 infants in the meta-analysis. The pooled coverage rates at day 0–1 after birth were 14.2% (95% CI: 10.1–18.9) for BCG and 1.3% (0.0–4.5) for HepB-BD. No data were available for OPV0 at day 0–1. The coverage at day 28 was 71.7% (63.7–79.2) for BCG, 60.8% (45.8–74.7) for HepB-BD, and 76.1% (67.1–84.0) for OPV0. No significant difference in the vaccine coverage was observed between infants born in healthcare facilities and those born outside facilities. Conclusions: The rates of vaccine coverage immediately after birth were very low for BCG and HepB-BD, and no data for OPV0. We need additional data to better define barriers and facilitators for the timely administration of the birth vaccines in sub-Saharan Africa, since the delay in its provision may increase the burden of these vaccine-preventable diseases. Full article
(This article belongs to the Special Issue Timely Administration of the Hepatitis B Birth Dose Vaccine)
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Review

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8 pages, 226 KiB  
Review
Implications of Birth-Dose Vaccination against Hepatitis B Virus in Southeast Asia
by Sheikh Mohammad Fazle Akbar, Mamun Al Mahtab, Ferdousi Begum, Shaikh A. Shahed Hossain, Sukumar Sarker, Ananta Shrestha, Md. Sakirul Islam Khan, Osamu Yoshida and Yoichi Hiasa
Vaccines 2021, 9(4), 374; https://doi.org/10.3390/vaccines9040374 - 12 Apr 2021
Cited by 12 | Viewed by 3022
Abstract
The World Health Organization (WHO) South-East Asia Regional Office (SEARO) covers 11 countries with a combined population of about 2 billion people, making it the most populous of the six WHO regions. In 1992, the WHO advocated including the hepatitis B vaccine in [...] Read more.
The World Health Organization (WHO) South-East Asia Regional Office (SEARO) covers 11 countries with a combined population of about 2 billion people, making it the most populous of the six WHO regions. In 1992, the WHO advocated including the hepatitis B vaccine in the Expanded Program of Immunization (EPI) and vaccinating all infants and children three times within 1 year of birth (HepB3). Recently, the WHO advocate birth-dose hepatitis B vaccination (HepB-BD) as soon as possible after birth, preferably within 24 hours. In 2016, the SEARO endorsed a regional hepatitis B control goal with a target of hepatitis B surface antigen (HBsAg) seroprevalence of ≤1% among children aged ≥5 years by 2020. Of the 11 SEARO countries, four achieved this target on schedule. Out of these four countries, two countries (Bangladesh and Nepal) have not adopted HepB-BD in EPI program. On the other hand, the coverage of HepB3 is not satisfactory in some SEARO countries, including India which adopted HepB-BD but could not achieve the overall target of SEARO. Thus, it is a point of debate whether emphasis should be placed on proper implementation of HepB3 or whether a new agenda of HepB-BD should be incorporated in developing countries of SEARO. The article discusses strengthening and expanding the Hepatitis B vaccination program in SEARO countries with an emphasis on HepB and HepB-BD programs. Full article
(This article belongs to the Special Issue Timely Administration of the Hepatitis B Birth Dose Vaccine)
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