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Call for all children to receive hepatitis B vaccination at birth

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All children around the world should receive the hepatitis B vaccination at birth, as recommended by the World Health Organization (WHO), according to a global expert on the disease.

Professor Harry Janssen, director of the Toronto Centre for Liver Disease in Canada, said vaccination at birth was the best way to protect children from hepatitis B.

“Birth dose vaccination will reduce new cases of hepatitis B among children worldwide to near zero”

Harry Janssen

Children were at risk from the virus “from the moment they are born” and not just when they reach puberty, he warned at this week’s Global Hepatitis Summit in Toronto.

The WHO recommends that all infants should receive their first dose of vaccine as soon as possible after birth, preferably within 24 hours.

But Professor Janssen noted that the UK, France, Sweden, Norway and Italy only gave the birth dose of the vaccine for children born to hepatitis B infected mothers.

In addition, he highlighted that some other developed countries, such as Canada, Germany, Austria and Ireland had no birth dose vaccination schedule at all for hepatitis B.

“All babies and young children face other risks of blood to blood transmission”

Harry Janssen

Professor Harry Janssen, who is chairing the summit, said: “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.

“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,” he said.

“However, all babies and young children face other risks of blood to blood transmission from the moment they are born,” he said. “This can happen through household contacts, at school playing together with other children and in many other places.”

Professor Janssen warned that even in countries that vaccinated at birth when the mother had hepatitis B, the system was prone to error and some mothers and babies could slip through the net.

Toronto Centre for Liver Disease

Harry Janssen

Harry Janssen

“This adds a lot of complexity to the system and mistakes can be made,” he said. “If that systems fails children will get unnecessarily infected with this terrible virus at birth.”

Professor Janssen was even critical of the UK’s decision, since 2017, to offer the first hepatitis B vaccination to babies at eight weeks.

“Why leave any babies exposed, even for eight weeks?” he said. “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 added: “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 two follow-up vaccinations can be combined with other vaccines given in their first year, and this protection will usually last their lifetime,” he said.

“Why don’t we end the lottery and ensure they are protected from birth”

Harry Janssen

The professor highlighted that the virus had the worst impact in babies or young children, since more than 90% of babies and young infants that caught it would develop a chronic infection.

In addition, up to 50% of young children between one and five years who were infected would develop a chronic hepatitis B infection, compared to only 5-10% of those aged over 18.

A recent study, published in the journal The Lancet Gastroenterology & Hepatology, showed that some 300 million people worldwide were infected with hepatitis B in 2016.

 

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