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Hepatitis B Vaccines

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Hepatitis B Virus and Liver Disease

Abstract

Since 1982, safe and effective hepatitis B virus (HBV) vaccines have been commercially available first derived from plasma of HBV infected persons and later from yeast cells using recombinant DNA technology. Hepatitis B vaccines have an overall efficacy of 80–100% and provide virtually complete protection against acute and chronic hepatitis B infection among persons who complete the three dose vaccination series.Despite decrease or loss of serologic evidence of an effective immune response over time, immune protection from hepatitis B vaccination lasts for more than 25 years. New hepatitis B vaccines are in development to help achieve long-term protection in hepatitis B vaccine hyporesponsive populations (e.g., HIV-seropositive patients, the elderly) and to decrease the number of doses required to achieve an effective immune response. The greatest health impact is achieved through childhood vaccination, as children infected with HBV at birth or early childhood are at greatest risk for developing chronic HBV infection and HBV-related liver disease in later life. Globally, universal hepatitis B vaccination is recommended for all infants beginning preferably within 24 hours of birth, full immunization of infants by routine immunization programs in the first three years of life, andcatch-up vaccination of unimmunized older children and adults. Evidence is growing that antiviral prophylaxis given in the last trimester of pregnancy to women with a high viral load of HBV can lower the risk for perinatal transmission of HBV. By 2010, as a result of multiple global initiatives, hepatitis B vaccination coverage among infants had reached an estimated 75% worldwide; coverage remains low in some countries and for newborns globally. Rates of HBV incidence, prevalence and liver cancer fall dramatically among vaccinated cohorts. As a result, hepatitis B vaccination is one of the most cost-effective public health interventions available, yielding a cost per life saved of $4–$36 in low-income countries. WHO has developed a framework for global action, with the goal of eliminating HBV and hepatitis C virus (HCV) as public health threats by 2030. Hepatitis B elimination can be achieved when countries implement comprehensive hepatitis B virus immunization programs including hepatitis B vaccine in national childhood immunization schedules, vaccinating newborns for hepatitis B and providing catch-up vaccination for children or adolescents, and adults.

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  1. Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA, USA

    John W. Ward M.D.

  2. Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium

    Pierre Van Damme M.D., Ph.D.

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    Jia-Horng Kao

  2. Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Genomics Research CenterAcademia Sinica, Taipei, Taiwan

    Ding-Shinn Chen

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Ward, J.W., Van Damme, P. (2018). Hepatitis B Vaccines. In: Kao, JH., Chen, DS. (eds) Hepatitis B Virus and Liver Disease. Springer, Singapore. https://doi.org/10.1007/978-981-10-4843-2_5

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