Hepatitis B vaccines for newborns are safe and cost-effective
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the evidence backs this
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Peer-reviewed literature demonstrates that universal hepatitis B immunization for newborns is both safe and a highly cost-effective strategy for preventing disease carriers.
The China GAVI Hepatitis B Immunization Project was initiated in 2002 with the signing of a Memorandum of Understanding between GAVI and the Government of China. The Project was one of the three (China, India, and Indonesia) GAVI-initiated special projects done to support countries too large to receive full GAVI support for hepatitis B vaccine and safe injections. The Project in China was designed by the Chinese Government and partners to deliver free hepatitis B vaccine and safe injections to all newborns in the 12 Western Provinces and Poverty Counties in 10 Provinces of Central China (1301 Counties with approximately 5.6 million births per year), eliminating the gap in immunization coverage between wealthier and poorer regions of China. The project budget (USD 76 million) was equally shared by GAVI and the Chinese Government. Initially planned for 5 years, two no cost extensions extended the project to 2011. Although China produced hepatitis B vaccine, before the project the vaccine was sold to parents who were also charged a "user fee" for the syringe and vaccine administration. Basic Expanded Program on Immunization (EPI) vaccines such as BCG, DTP, Polio, and measles vaccines were provided free to parents, although they were charged a user fee. Vaccines were sold by China CDC Offices at provincial, prefecture, county level and township hospitals, and village doctors received a substantial portion of their income from the sale of hepatitis B and other vaccines. The result
Hepatitis B infection is a major global health problem with a high morbidity and mortality. With safe and effective vaccines available, it is now possible to prevent it. Many countries have started national hepatitis B control programmes but no attempt has been made to do this in our country. An analysis of the available data on the epidemiology of hepatitis B infection in India reveals that perinatal maternofoetal transmission accounts for only a minority of hepatitis B virus carriers in India. Therefore, a policy of screening pregnant mothers for the presence of hepatitis B surface antigen and selective immunization of babies born to those who are surface antigen positive will have very little effect on the hepatitis B carrier rate in our population. Universal immunization of all newborns will have a much greater impact, it will be logistically simpler and more cost-effective--the cost of preventing one hepatitis B carrier being nearly one-fourth of that with selective immunization. We recommend that hepatitis B vaccine should be included in our country's expanded programme of immunization.
Fifty-eight percent of the nearly 8 million deaths in children under the age of 5 years in 2010 were due to infectious diseases [1]. The majority could have been prevented by known, simple, affordable and low cost interventions, including infant immunization [1]. The Expanded Program on Immunization (EPI) and complementing national immunization programs undoubtedly represent major triumphs of preventive medicine and public health [2,3], resulting in a reduction from 12 million deaths in 1990 to 7.6 million in 2010 [1]. However, in 2010, approximately 3 million children under 5 years of age still died of infectious diseases that could have been prevented with currently available vaccines [3]. To avert these deaths, infant immunization needs to become more common and complete. This, in turn, requires vaccines that are more effective in the very young, easy to administer, and acceptable as well as affordable on a population basis [2]. Over the last decade much has been learned about the immune responses to vaccines administered early in life. Key progress in this field is reviewed by leading experts for this Special Edition. For example, Ota and colleagues highlight how the complex interaction of biological, socio-economic and ethical issues can influence immune responses to vaccines administered in the first year of life. In their review of animal models for neonatal diseases in humans, Levast and colleagues outline the many advantages and disadvantages of each. Levy et al. the
index. ISBN 0-8247-8780-3 1. Hepatitis B— Vaccination. 2. Hepatitis B vaccine. I. Ellis, Ronald … with the hepatitis B virus (HBV). The long-term sequelae of chronic hepatitis B include a … The first-generation hepatitis B vaccines, derived from hepatitis B surface antigen (HBsAg)
vaccination of children for hepatitis B was initiated. Types of Hepatitis B Hepatitis B can appear in two forms: … who has chronic hepatitis B Hepatitis B in Infants Infants who contract hepatitis B from their mothers … of hepatitis B immune globulin (see “Hepatitis B Immune Globulin”). The first dose of hepatitis B vaccine
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