Most developed countries routinely immunize all their children against hepatitis B, but the UK doesn’t. This means most UK citizens are susceptible to hepatitis B infection, according to an article published in the British Medical Journal (BMJ), this week’s issue.

Even though the WHO (World Health Organization) has called for the universal immunization against hepatitis B, the UK still does not routinely vaccinate its children, the author, Andrew Pollard, Reader in Pediatric Infection and Immunity at Oxford University, explains.

Earlier this year the British Medical Association urged the Department of Health to introduce the hepatitis B vaccine into the childhood schedule immediately.

As the incidence of hepatitis B in the UK is extremely low, much lower than in other countries, authorities say there is no good reason to introduce universal immunization. However, much lower than other countries does not mean the numbers are ignorable. 180,000 people in the United Kingdom are chronically infected with the hepatitis B virus – about 7,700 new infections occur annually.

As British people are traveling abroad more their exposure to the virus grows.

Around 40% of infections are transmitted during birth from mother to child, or very early in childhood through contact with blood or body fluids. Immunization can control, and eventually eliminate the virus, Pollard explains.

The young populations of countries that did introduce universal childhood immunization during the past 15 years have a new generation of young people among whom transmission is being interrupted.

Authorities in the UK prefer a strategy of targeted immunization to control virus transmission from mother to child. However, the most effective and cheapest way to protect UK kids is to add the hepatitis B vaccine to UK primary immunization schedule early during infancy – an approach that is widely used in Europe, writes Pollard.

Currently, infant immunization alone is also inadequate to curb transmission of the virus, because of ongoing transmission among non-immune adults and the difficulty in detecting and getting to people at risk.

Consequently, Pollard stresses that the existing targeted program which focuses on high risk groups, such as injecting drug users, prisoners, etc., needs strengthening to lessen the burden of new infections until those in a universal immunization program become adults.

Pollard adds that the new proposal to introduce vaccination to combat cervical cancer in pre-adolescents from 2008 could provide a means for implementing a concomitant adolescent hepatitis B program to prevent liver cancer. This would generate a group of immune people more quickly than universal infant immunization alone and accelerate the control of the hepatitis B virus in the UK.

“Editorial: Hepatitis B vaccination”
Andrew Pollard
BMJ 2007;335:950
doi: 10.1136/bmj.39315.677396.BE
http://www.bmj.com

Written by – Christian Nordqvist