Progress toward elimination of hepatitis B virus transmission in the United States

The strategy to eliminate hepatitis B virus (HBV) transmission in the Unite d States is comprised of the following components: (1) preventing perinatal transmission, (2) routine infant vaccination, (3) catch-up vaccination of children in high-risk groups at any age, (4) catch-up vaccination of all ch ildren at 11-12 years of age and (5) vaccination of adolescents and adults in high-risk groups. According to recent surveys, >85% of pregnant women ar e screened for hepatitis B surface antigen (HBsAg). Of infants born to HBsA g-positive women identified in 1995, 93% received appropriate immunoprophyl axis at birth; however, only 69% were fully vaccinated by 6-8 months of age . From 1991 (when routine infant hepatitis B vaccination was first recommen ded) to 1996. the proportion of 19-35-month-old children who have received three doses of hepatitis B vaccine has increased from < 10 to 83%. During t his lime, rates of acute hepatitis B in children 7-10 years of age have dec lined by 27% and rates among children 3-6 years of age have declined by 62% . Implementation of programmes for catch-up vaccination of all adolescents at 11-12 years of age and for vaccination of adolescents and adults in high -risk groups have only recently begun and no data are available to assess t he progress of these programmes. However, 26% (13/50) of states now have la ws requiring adolescents to be vaccinated in order to enter school. Current data indicate that substantial progress has been made in implementing a st rategy to eliminate HBV transmission in the United States. Future efforts n eed to be focused on improving complete immunoprophylaxis of infants of HBs Ag-positive mothers, increasing vaccine coverage among 11-12 year old child ren and implementing programmes to vaccinate adolescents and adults in high -risk groups. Published by Elsevier Science Ltd