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Hepatitis B Seroepidemiology in Australia, One Decade After Universal Vaccination of Infants and Adolescents

[ Vol. 20 , Issue. 3 ]


Xinting Lu*, Helen E. Quinn, Rob I. Menzies, Linda Hueston, Lyn Gilbert and Peter B. McIntyre   Pages 341 - 347 ( 7 )


Background: This study assessed the impact of the staged introduction of universal infant and adolescent catch-up hepatitis B vaccination programs on the prevalence of immunity and past hepatitis B virus (HBV) infection in targeted cohorts over almost a decade in Australia.

Methods: We compared the prevalence of immunity in relevant cohorts of children and adolescents in repeated national serological surveys conducted in 1998-99, 2002 and 2007. Residual sera (n =2210) collected opportunistically from Australian laboratories in 2007 were tested for antibody to hepatitis B surface antigen (anti-HBs) indicating vaccine-induced immunity; sera from individuals aged 12-29 years with anti-HBs detected (n =386) were then tested for hepatitis B core antibody (anti-HBc) to identify past hepatitis B infection.

Results: In 2007, compared with the baseline period of 1998-99, anti-HBs prevalence had increased significantly in all age groups below 24 years, by more than double in target children. Prevalence of anti-HBc was zero in the 12-14 years and reduced by 71% in those aged 15-19 years. The hepatitis B vaccination protected a significant number of targeted adolescents with a modest vaccine uptake (57% to 60% nationally).

Conclusion: In a setting without incentives or school entry requirements, adolescent vaccination coverage was significantly higher when delivered by school-based rather than GP-based mechanisms. A cohort of children was growing up in Australia with a high prevalence of vaccineinduced immunity against hepatitis B, providing the best opportunity for controlling HBV infection in Australia.


Hepatitis B, seroepidemiology study, adolescent, universal hepatitis B vaccination, Australia, infection.


School of Public Health, University of Sydney, Sydney, National Centre for Immunisation Research & Surveillance (NCIRS), The Children's Hospital at Westmead, Sydney, School of Public Health and Community Medicine, UNSW, Centre for Infectious Diseases and Microbiology – Public Health, Institute for Clinical Pathology and Medical Research (ICPMR), Westmead, Sydney, Marie Bashir Institute for Emerging Infections and Biosecurity, University of Sydney, Sydney, National Centre for Immunisation Research & Surveillance (NCIRS), The Children's Hospital at Westmead, Sydney

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