Experts call for all children worldwide to receive hepatitis B vaccination at birth

Embargo: 0501H UK time (0001H Toronto time) Friday 15 June

Experts at this week’s Global Hepatitis Summit in Toronto, Canada (June 14-17) are calling for all children globally to receive the hepatitis B vaccination at birth, as recommended by the World Health Organization (WHO)*. The host nation Canada**, Germany, Austria and Ireland are the developed countries that do not have a birth dose vaccination schedule for hepatitis B, whereas a host of others, including the UK, France, Sweden, Norway and Italy only have the birth dose for children born to hepatitis B infected mothers.

“The best way to protect all children from potential infection with the hepatitis B virus is with a vaccination with 24 hours of birth, as recommended by WHO,” says Professor Harry Janssen, Director of the Toronto Centre for Liver Disease, based at the University of Toronto and Toronto General Hospital, ON, Canada.

“There is a misconception that we only need to offer older children vaccination in the years before they become sexually active, since sexual activity is one of the routes of transmission. However, all babies and young children face other risks of blood to blood transmission from the moment they are born. This can happen through household contacts, at school playing together with other children and in many other places.”

He adds that even in countries that vaccinate children at birth only when the mother has hepatitis B, this system is prone to error and some mothers and babies could slip through the net. “This adds a lot of complexity to the system and mistakes can be made. If that systems fails children will get unnecessarily infected with this terrible virus at birth,” says Professor Janssen, who is the Chair of The Global Hepatitis Summit.

Furthermore, not only are infants and young children among those at the highest risk for infection, hepatitis B has the worst impact when it infects babies or young children, since more than 90% of babies and young infants that are infected will develop a chronic hepatitis B infection -chronic infections can, if left untreated, cause progression to liver cirrhosis, liver cancer, and death.  While the risk of this progression is highest when infected under age 1 year, up to 50% of young children between 1 and 5 years who are infected will also develop a chronic hepatitis B infection. For anyone over 18, only 5-10% of those infected will go on develop chronic hepatitis B.

WHO recommends* that all infants should receive their first dose of vaccine as soon as possible after birth, preferably within 24 hours. In some parts of Canada including Ontario, the home of 38% of Canada’s population, most children are not vaccinated until 12 years old. Even in countries where improvements have been made, things could be made better still. For example, the UK is now offering the first hepatitis B vaccination to babies at 8 weeks (since 2017). “But why leave any babies exposed, even for 8 weeks?” asks Professor Janssen. “If eventually all children will be offered this vaccine anyway in most developed countries, why don’t we end the lottery and ensure they are protected from birth, when potential infection has the worst impact?”

He adds: “Birth dose vaccination will reduce new cases of hepatitis B among children worldwide to near zero and remove the chance that any of them will become chronically infected. It is also much easier logistically to vaccinate children at birth because after the first dose the 2 follow-up vaccinations can be combined with other vaccines given in their first year, and this protection will usually last their lifetime.”

A recent study** published in The Lancet Gastroenterology & Hepatology by Dr Homie Razavi and colleagues shows that some 300 million people worldwide are infected with hepatitis B.

Notes to editors:

Click here for a global graph showing which countries are implementing birth dose vaccination for hepatitis B

*Click here for details on WHO recommendations for hepatitis B vaccination

**For details of the different hepatitis B vaccination policies across Canadian Provinces and Territories, please click here  and scroll down the page (Source: Government of Canada: Canadian Immunization Guide)

***the latest data on hepatitis B estimates were published by The Polaris Observatory, Center for Disease Analysis, Lafayette, CO, USA. See:

Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study (published March 2018)

Media coverage (note this work was especially targeted to Canadian Media)

The Conversation Canada

The Times, UK

CTV News, Canada

The Globe and Mail, Canada

The National Post, Canada

2018-12-13T12:35:52+00:00