Hepatitis B virus (HBV) infection remains a major global health problem, with nearly 300 million people worldwide chronically infected. To address this public health challenge, the World Health Organization (WHO) has set a goal of eliminating HBV by 2030 and emphasized the importance of achieving 90% infant vaccine coverage. However, ongoing challenges with awareness and misinformation may hamper the agency’s efforts.
There is no shortage of data demonstrating the effectiveness of the hepatitis B vaccine in preventing infection, but preventing chronic infection also brings the added benefit of reducing the incidence of liver failure, cirrhosis, and other related comorbidities. Still, over the past 30 years, questions have been raised about long-term protection and vaccine-evading mutants. However, many fears have been put to rest due to the continued protection of most populations and most areas, and no real progress being made by mutants.
Perhaps the most important recent factor affecting HBV infection rates and vaccination status is the COVID-19 pandemic, but it is too early to tell how large the impact will be. Multiple studies have shown that confidence in vaccines has decreased or vaccine hesitancy has increased in light of vaccination campaigns against COVID-19. This is true not only for HBV vaccine but also for other routine immunizations, with some models suggesting that a 20% reduction in vaccine coverage in 2020 would result in more than 500,000 additional chronic HBV infections and increased mortality, particularly in Africa and the Middle East. Western Pacific Region. While lockdowns suppressed transmission in some groups, poor levels of hepatitis B virus testing and vaccination following the pandemic have not helped quell new infections.
The CDC’s most recent update shows that the number of new hepatitis B virus infections has declined in 2020 and 2021, with a significant decline in 2020 and a further 14% decline in 2021. The authors noted that although 2 indicators of new HBV infections met annual targets for 2021, “it is difficult to determine the extent to which lower incidence rates are attributable to a true reduction in disease burden and the impact of the COVID-19 pandemic on health care.” , hepatitis testing and the health department’s ability to investigate viral hepatitis cases.”
Notably, historical case reports of adverse events, particularly in multiple sclerosis, have had a lasting impact on vaccination rollout in some countries, including France and China. Although these associations are unfounded, social media, especially through the COVID-19 pandemic, has contributed to the spread of false information. Another significant barrier is low birth dose coverage, which has also increased during COVID-19 due to vaccine hesitancy. Outside of the pandemic, access to infant vaccinations remains a problem in Africa and Asia, where rates of maternal transmission are highest. Notably, data collected from the U.S. population from 2018 to 2020 show racial disparities in hepatitis B birth-dose vaccination, with Asian Americans having the highest vaccination rates and African Americans experiencing high levels of vaccine hesitancy .
“In contrast to COVID-19, no biological barriers exist that reduce the effectiveness of HBV vaccines,” the authors concluded. “However, there are still many obstacles to the effective eradication of this harmful disease, such as the availability of vaccines and the lack of awareness of the beneficial relationship between the risk of contracting hepatitis B and the benefits of vaccination, as well as vaccine hesitancy (vaccine hesitancy) .”
The authors believe that most of these issues can be addressed through appropriate educational campaigns, which have been shown to help overcome vaccine hesitancy in other contexts. Examples from different countries demonstrate the impact of targeted information dissemination via the internet and social media, especially in marginalized communities where cultural sensitivity and addressing language barriers are key to success.
Pujol FH, Toyé RM, Loureiro CL, Jaspe RC, Chemin I. Hepatitis B eradication: vaccines a key player. American Journal of Translation Studies. 2023;15(8):4971-4983.