IMPLEMENTING UNIVERSAL VACCINATION PROGRAMS - BULGARIA

Universal vaccination against hepatitis B virus (HBV) was introduced f or all newborns in Bulgaria in August 1991, after a three-year selecti ve immunization of babies born to HBsAg-positive mothers. In 1992, a c over age level of 71.3% was achieved, Since 1989, hepatitis B morbidit y among infants shows a continuing downward trend with the lowest annu al incidence rare, 0.3 cases per 100 000, in 1992. This represents an 82% decrease compared to the preimmunization period. As strong epidemi ological evidence exists that an early age of infection substantially increases the overall burden of chronic HBV infection, future expansio n of vaccination coverage to include all children up to 6 years of age was considered an appropriate alternative to the existing policies.