Survey of coverage,strategy and cost of hepatitis B vaccination in rural and urban areas of China

AIM In order to understand the coverage, immunization strategy and cost of hepatitis B (HB) vaccination of China in recent years. METHODS A two stage household random sampling method was used in the survey. RESULTS The survey carried out at 112 Disease Surveillance Points (DSPs) of 25 provinces, autonomous regions and municipalities of China in 1996, showed that the coverage rates of HB vaccination among neonates were 96 9% in the urban DSPs and 50 8% in the rural DSPs in 1993-1994, while in students aged 7-9 years, they were 85 8% and 31 5% in 1994, respectively. Up to 1994, 97 5% of the urban DSPs and 73 9% of the rural DSPs on a neonate vaccination against HB program were included in EPI. About 93% of the urban DSPs and 44% of the rural DSPs did HBsAg and HBeAg screening for all or part of pregnant women. The neonates received the regimen of high dose HB vaccine in combination with hepatitis B immune globin (HBIG) if their mothers were HBsAg and/or HBeAg positive in pregnancy, otherwise they received the low dose vaccine (10μg×3). Part of DSPs had a lower neonate coverage due to unreasonable allocation of the vaccines (used for adults not at risk) or higher cost or insufficient supply of the vaccines. It is necessary to evaluate the quality of serological lab test to HBVMs in the maternal prescreening. CONCLUSION Remarkable achievements have been made according to the national planning and policy of HB immunization in China.

Hepatitis B Vaccination Coverage among University Students in Sub-Saharan Africa: Systematic Review and Meta Analysis

Introduction: Hepatitis B is an infectious disease that remains a real public health problem in Africa. Students represent a group at risk for this disease. The objective of this study was to estimate the hepatitis B vaccination coverage rate among students in sub-Saharan Africa. Methods: A systematic search of databases (PubMed, AJOL) and a manual search of Google Scholar was conducted to retrieve all published studies reporting hepatitis B vaccination coverage among students in sub-Saharan Africa. The pooled coverage rate was estimated with a 95% confidence interval (CI) in a random-effects meta-analysis. Results: A total of 35 studies were included and included 20,520 students. The mean age was 22.1 ± 5.1 years with a predominance of female sex (sex ratio F/M = 1.05). The vaccination coverage rate was 28.8% [95% CI: 22.9% - 34.7%]. Disaggregation allowed to estimate coverage rates of 29.8% [95% CI: 22.9% - 36.7%], 23.4% [95% CI: 9.4% - 37.4%] and 17.0% [95% CI: 14.4% - 19.5%] respectively in West Africa, East Africa and Central Africa. Conclusion: Less than a third of students in sub-Saharan Africa are protected against hepatitis B. However, the majority of this target group is at risk of infection. It would be relevant to screen and, if necessary, vaccinate all new students.

Testing for hepatitis B virus alone does not increase vaccine coverage in non-immunized persons

AIM To determine whether hepatitis B virus(HBV)-testing could serve as a gateway to vaccinate non-immunized individuals in a low-prevalent country.METHODS Non-immunized subjects participating in a multi-center, HBV-testing campaign in Paris, France were identified and contacted via telephone 3-9 mo after testing in order to determine vaccination status. Vaccination coverage was evaluated in per-protocol(for all respondents) and intent-to-treat analysis(assuming all non-responders did not vaccinate).RESULTS In total, 1215/4924(24.7%) enrolled subjects with complete HBV serology were identified as nonimmunized and eligible for analysis. There were 99/902 successfully contacted subjects who had initiated HBV vaccination after screening: per-protocol, 11.0%(95%CI: 9.0-13.2); intent-to-treat, 8.2%(95%CI: 6.7-9.8). In multivariable analysis, vaccination was more likely to be initiated in individuals originating from moderate or high HBV-endemic countries(P < 0.001), patients with limited healthcare coverage(P = 0.01) and men who have sex with men(P = 0.02). When asked about the reasons for not initiating HBV vaccination, the most frequent response was "will be vaccinated later"(33.4%), followed by "did not want to vaccinate"(29.8%), and "vaccination was not proposed by the physician"(21.5%). Sub-group analysis indicated a stark contrast in vaccination coverage across centers, ranging from 0%-56%.CONCLUSION HBV-vaccination after HBV screening was very low in this study, which appeared largely attributed to physician-patient motivation towards vaccination. Increased vaccination coverage might be achieved by emphasizing its need at the organizational level.

Hepatitis B Vaccination Rate among Medical Students at the University of Port Harcourt Teaching Hospital (Upth)

Background: Hepatitis B virus (HBV) infection causes significant morbidity and mortality worldwide. Occupational exposure of health care workers and medical students increases their risk of acquiring HBV infection, and many authorities recommend vaccination. However, significant proportions of health care workers do not receive HBV immunization, and remain at increased risk to HBV infection. Objective: To determine the hepatitis B vaccination rate among Medical students at the University of Port Harcourt Teaching Hospital (UPTH) and to determine their knowledge of HBV infection. Result: Three hundred and sixteen medical students at UPTH completed self-administered questionnaires which included questions about demographic characteristics, HBV vaccination status, knowledge of hepatitis B vaccine and reasons for not receiving the vaccine. All (100%) of the respondents had heard of hepatitis B vaccine. Two hundred and twenty two (70.2%) of them thought they were at risk of acquiring hepatitis. Two hundred and seventy (85.4%) had received at least one dose of hepatitis B vaccine while 46 (14.6%) had never received the vaccine. One hundred and ten of the respondents had received 3 doses of hepatitis B vaccine, giving a vaccination rate of 34.8%. One hundred and sixteen (36.7%) had received 2 doses, while 44 (13.9%) had received one dose. There was a statistical significant relationship among marital status (p = 0.01), clinical level (p = 0.02) and hepatitis B vaccine uptake. Conclusion: The hepatitis B vaccination rate among medical students at the University of Port Harcourt Teaching Hospital is low. National and institutional legislation for adult vaccination against Hepatitis B should be promulgated for those at higher risk.

A Study on Long-term Efficacy and Immunologic Persistence of Hepatitis B Plasma Vaccine Made in China

In order to demonstrate the long term protective efficacy and immunologic persistence of domestically made hepatitis B plasma derived vaccine, 371 children had been followed up for 5 to 8 years after primary vaccination (10 μg×3). The results showed that the positive rate of antibody to hepatitis B surface antigen (anti HBs) in 371 subjects was 77.6% and the geometric mean titre (GMT) of anti HBs was 47.32 IU/L. The anti HBs positive rates in the subjects who had been vaccined for five, six, seven and eight years remained 83.91%, 73.68%, 81.25% and 72.24%, respectively, while the GMTs were 59.53, 43.64, 42.21 and 46.20 IU/L, respectively. The protective efficacy rate of hepatitis B vaccine was 94.26% if both HBsAg and anti HBc were considered as infective indicators, and 88.28%, if only HBsAg positive cases were taken into account. The study indicated that the domestically made hepatitis B vaccine could provide at least 5 to 8 years protection against hepatitis B infection.

The Association of Hepatitis B Vaccine Supply Policy with Timing of Receipt of the First Dose of Hepatitis B Vaccination

An estimated 800,000 - 1.4 million persons in the US have chronic hepatitis B virus (HBV) infection. The risk for chronic infection is greatest among young children;approximately 90% of infants will remain chronically infected with HBV. Approximately 25% of those who become chronically infected during childhood die prematurely from cirrhosis or liver cancer. Hepatitis B vaccination is the most effective measure to prevent HBV infection and its consequences. In 2006, 29 US states had Hepatitis B Vaccine Supply (HBVS) policy which either supplies hepatitis B vaccine at no cost to all providers for all children or provides hepatitis B vaccine to delivery hospitals-only free of charge for all infants;other 21 US states and the District of Columbia did not have. 17,636 infants born in 2006 obtained from 2007-2009 National Immunization Survey (NIS) were analyzed with survival analysis procedures of Kaplan-Meier estimate and Cox proportional hazards model for complex sample survey to evaluate the association between state HBVS policy and the timing of infant age in days to receipt of hepatitis B vaccination. State HBVS policy is associated with infant age in days from birth to receipt of the first dose of hepatitis B vaccine (P < 0.01), and to completion of the 3-dose hepatitis B vaccine series (P < 0.01). Receipt of the first dose of hepatitis B vaccine occurred 31% earlier among infants residing in states with HBVS policy than among infants residing in states without (adjusted hazards ratio 1.31, 95%CI (1.23, 1.39)). Completion of the 3-dose hepatitis B vaccine series were 12% sooner among infants living in states with HBVS policy than among infants living in states without (adjusted hazards ratio 1.12, 95%CI (1.06, 1.18)). State HBVS policy may help overcome barriers to timely delivery of hepatitis B vaccines to infants.

SIX-YEAR EFFICACY OF HEPATITIS B REVACCINATION:A DOUBLE-BLIND,PLACEBO-CONTROLLED AND RANDOMIZED FIELD TRIAL

in order to observe the efficacy or a booster dose of hepatitis B vaccine, ic4 primaryschool children with a good response were enrolled in a double-bind, placebo-controlled and randomized field trial three years after the primary vaccination. At the end of the 6-year follow-up anti-HBspositive rate and GMT (of S/N value) In the revaccinated group were 54. 5% and 12. 0. still higherthan those in the control group (40. 5 % & 4. 8), but the difference of the positive rates was not statistically significant this time. Anti-HBs I,osltlve rate and GMT not only in the control group but inthe revaccinated group had dramatically declined against those 3 years arter the revaccination (thecontrol group: 69. 4 % & 20. 6 1 the revaccinated group: 87' 8% & 43. 3) (P < 0. of ). The higher anti-HBs titer before the revaccination, the better the persistence of anti-HBs after the revaccination.HBV infection rate (calculated by person-year) In the revacclnated group was l' 44%, without statistical difference from 3. 19% In the control group (P > 0. 05) as before. Considering the perfect longterm efficacy of hepatitis B vaccine, we concluded that a booster dose 9 years arter the primary immunization seems unnecessary.

Impact of Hepatits B Vaccination as an Important Indicator for Immunization Program in Albania

Albania has been a country with a high prevalence of hepatitis B virus. Hepatitis B vaccine has been introduced nationwide in Albanian Immunization Program in 1994. Hepatitis B is given at birth, as a separate antigen, followed by three doses at 2, 4 and 6 months, where Hepatitis B, starting from 2009, is part of pentavalent vaccine of DTP-HepB-Hib. The aim of this study was to evaluate Immunization Program with Hepatitis B vaccination in order to prove program efficacy, increase public confidence in immunizations and advocate for sustainable immunization programs. Methodology was based on three components such as Immunization coverage surveys, serologic surveys and surveillance for acute cases of Hepatitis B. Results of this study showed that vaccination coverage is really high, more than 95% all over the country and with drop-out rates less than 10%. Anti-HBs levels in immunized children were very high in comparison with unimmunized ones. Incidence of HBV in children 0-14 years old is almost zero. Such results tell us that Hepatitis B vaccination is one of the most fruitful strategies for long term control of Hepatitis B disease.

Knowledge, Attitudes, and Practices (KAP) Regarding Hepatitis B Vaccination among Healthcare Workers in Mongolia

Background: Mongolia is no exception and experiencing the burden of HBV among the population. In the last decade, the prevalence of HBV among the relatively healthy population of Mongolia has ranged between 11.8 percent and 10.6 percent, and acute cases are between 1.7 and 1.1 per 10,000 people. We aimed to determine healthcare workers (HCWs) knowledge, attitude, and practices regarding HBV prevention compared to vaccination coverage. Methods: This cross-sectional study was conducted among HCWs from the selected sites through multi-stage sampling. The study involved 1135 HCWs, including medical doctors, nurses, clinicians in both surgical and medical specialties, laboratory technicians, and other staff working in all departments from primary and referral levels in 36 healthcare facilities in two urban and four rural provinces of Mongolia. Participants who consented to the study completed a standardized self-administered questionnaire between July and Dec 2019. Results: Most participants (82.0%) were born before 1992 or before starting a birth vaccination against HBV in Mongolia. The mean age of the participants was 38 years and the participants’ median employment year in the health sector was seven years. Most participants were medical doctors (29.1%) and nurses (28.0%). Five questions explored HCWs’ knowledge about hepatitis B virus infection and prevention, and the correct response ranged between 15.6% and 95.4%. 2.8% of the respondents answered five questions correctly. Men, those with higher levels of education, those over the age of 30, soum family health center HCWs, and doctors and senior medical professionals answered many questions correctly, which is statistically significant. 98.9% of respondents believe that HCWs should vaccinate against HBV. The younger the age (%), management professionals, and service staff are confident in vaccines. A significant difference between age groups, perception of HBV infection, and formal attendance to the official training positively relate to vaccination coverage. Specially survey respondents who knew about the adverse effects of overdosing, learning about total doses of the vaccine, and the effectiveness of the hepatitis B vaccine were more tent to have full doses of the HBV vaccine. Knowledge and working conditions are increasing factors in receiving full doses of the HVB vaccine. Conclusion: The overall knowledge of HBV and its vaccination is fair among the HCWs;however, there is a need to intensify the training on some of the details and increase the training frequency at the workplace. Attitude and practice on infection protection and vaccination are still essential to be promoted among the HCWs. The low level of vaccination coverage is relevant to the level of KAP among the HCWs of the country.

接种乙肝疫苗对人群HBVM模式的影响

目的 :了解乙肝疫苗接种以来 ,山东省人群中乙肝感染指标和感染模式的变化情况 ,为评价疫苗免疫预防效果 ,制订乙肝防治策略提供依据。方法 :采用多级分层整群随机抽样的方法 ,抽取全省 11个县 (市区 )的 74 19人进行了乙肝疫苗接种情况的调查 ,并用固相放射免疫法检测其乙肝血清学指标。结果 :人群乙肝疫苗接种率为 2 8.2 1%。 HBs Ag、抗- HBs总阳性率分别为 5 .0 5 %、 4 5 .2 6 % ,其中未接种组为 5 .88%、 36 .14 % ,接种组为 2 .96 %、 6 8.4 7%。两组差异均有统计学意义 (P<0 .0 1)。抗 - HBs阳性率城市均高于农村 (P<0 .0 1)。结论 :接种乙肝疫苗能有效的提高抗 - HBs阳性率 ,减少乙肝病毒感染率 ,是控制乙肝发病的有效措施。

儿童接种乙型肝炎疫苗后不同时间HBsAb阳性率评价

目的观察儿童接种乙型肝炎(简称乙肝)疫苗后不同时间的乙肝表面抗体(HBsAb)阳性率。方法回顾性研究2006年1月至2018年3月于首都医科大学附属北京同仁医院进行检查的4831例儿童血清学数据,接种乙肝疫苗后按时间分为接种当年、接种后1年、2年、3年、4年、5年、6年、7年、8~14年等九组和按性别分为女性儿童和男性儿童两组进行HBsAb阳性率统计分析。结果4831例儿童中,HBsAb总体阳性率约为73.00%,接种1年后随时间延长HBsAb阳性率均逐年下降,除接种后1年以内和接种后5年、6年以外,女性儿童HBsAb阳性率均明显高于男性儿童,1年组女性儿童和男性儿童分别为88.74%和84.37%,7年组女性儿童和男性儿童分别为69.12%和58.65%差异具有统计学意义(P<0.05)。结论儿童接种乙肝疫苗后,HBsAb滴度会随接种后时间延长而降低,应适时检测HBsAb水平,女性儿童HBsAb阳性率高于男性儿童,应结合实际情况加强免疫,以降低乙肝患病率。

大理州2019年人群乙型肝炎疫苗接种情况和HBV血清学调查分析

目的了解大理州8月龄以上人群乙型肝炎(乙肝)疫苗接种情况和免疫水平,为今后有效开展乙肝疫苗接种工作提供依据。方法采用分层整群抽样方法进行抽样,每个县市按大理州历年乙肝疫情和常规免疫工作开展情况平均分为高、中、低3层,每一层调查3个点,每个县市共调查9个点,每个点调查8个年龄组,即8~17月龄、18~35月龄、3~6岁、7~14岁、15~24岁、25~34岁、35~44岁,≥45岁,抽取3732名调查对象,于2019年5—6月开展调查工作,调查乙肝疫苗全程接种率,应用酶联免疫吸附法定性检测HBs Ag、HBs Ab、HBc Ab。结果 2019年大理州标化全人群乙肝疫苗全程接种率为23.69%,易感率为54.47%,免疫率为39.36%,感染率为2.20%。8~35月龄、3~14岁、≥15岁3个年龄组的接种率分别为99.23%、98.13%、8.13%,易感率分别为9.16%、49.29%、59.98%,免疫率分别为88.72%、47.97%、33.07%,感染率分别为0.19%、0、2.63%。不同年龄组接种率(χ^(2)=3093.171,P=0.000)、易感率(χ^(2)=780.190,P=0.000)、免疫率(χ^(2)=822.316,P=0.000)、感染率(χ^(2)=46.208,P=0.000)不同,接种率、免疫率随年龄增长呈下降趋势,易感率、感染率随年龄增长呈上升趋势;男性和女性接种率分别为68.91%、46.02%,易感率分别为38.60%、46.48%,免疫率分别为56.50%、49.16%,不同性别接种率(χ^(2)=191.391,P=0.000)、易感率(χ^(2)=27.501,P=0.000)、免疫率(χ^(2)=19.493,P=0.000)比较差异有统计学意义。结论大理州居民对乙肝已建立一定免疫屏障,但整体水平不高,应加强查漏补种工作并对易感率较高的人群开展强化免疫接种,重点开展15岁以上免疫空白人群的接种工作。

不同剂量CHO重组乙肝疫苗免疫效果及联合HBIG阻断母婴传播效果研究

目的 为探讨不同剂量CHO重组乙肝疫苗免疫效果及其联合HBIG阻断母婴传播的效果。 方法 采用血清流行病学的方法对CHO重组乙肝疫苗的免疫效果及联合HBIG阻断母婴传播效果进行追踪调查。 结果 乙肝疫苗不同免疫方案对HBsAg阴性产妇的新生儿产生抗 -HBs滴度 (GMT)的差异无显蓍的统计学意义 ;CHO重组乙肝疫苗2 0 μg -2 0 μg -2 0 μg组与其首针同时联合臀部肌肉注射HBIg 10 0IU组对产妇HBsAg、HBeAg单、双阳性的新生儿的母婴传播阻断率的差异有显著的统计学意义 (P <0 .0 5 )。 结论 CHO重组乙肝疫苗能产生较好的免疫效果 ,对HBsAg阴性产妇的新生儿采用CHO重组乙肝疫苗 2 0 μg -10 μg -10 μg进行免疫更为经济有效 ;CHO重组乙肝疫苗 2 0 μg -2 0μg -2 0 μg且首针同时联合臀部肌肉注射HBIg 10 0IU组阻断母婴乙肝传播效果优于单独使用CHO重组乙肝疫苗 2 0 μg-2 0 μg -2 0 μg组。

中山市三乡镇幼儿园新生乙型肝炎疫苗接种率与HbsAg阳性率关系调查分析

目的 :为了解学龄前儿童乙型肝炎疫苗接种率与HbsAg阳性率关系状况。方法 :从2000～2003年每年对所有新入中山市三乡镇各幼儿园的儿童调查乙型肝炎疫苗接种史和用ELISA方法检测HbsAg。结果 :2000～2003年共调查2663名儿童 ,乙型肝炎疫苗接种率为88.32 % ,2000年与2002、2003年的接种率差异有显著性 (x2=4.89、6.92 ,P均<0.05)。HbsAg阳性率为1.01 % ,2000～2003年HbsAg阳性率差异无显著性(x2=4.47,P>0.05) ,有乙肝疫苗接种史和无接种史的HbsAg阳性率分别为0.34 % ,6.11 % ,其差异有非常显著性 (x2=91.09 ,P<0.005)。结论 :乙肝疫苗接种率的提高 ,能有效阻断HbsAg的传播 ,该区域学龄前期儿童HbsAg阳性率处于较低水平。

2015-2017年安溪县医院产妇HBV感染情况及新生儿首剂乙肝疫苗接种情况调查

目的调查2015-2017年福建省安溪县医院HBs Ag阳性产妇和新生儿首诊接种的及时接种情况。方法选取2015-2017年在安溪县医院产科住院分娩的全部产妇14 760例和新生儿14 791例,对产妇年龄、常住地、有无乙肝接种史等信息分析乙肝感染情况,对所生新生儿的首诊接种率和及时率情况进行分析。结果①2015-2017年共收治住院分娩产妇14 760例,1221例产妇为HBs Ag阳性,感染率为8.27%;②HBs Ag阳性率无乙肝接种史产妇均明显高于有乙肝接种史产妇;③30岁以内,随着年龄增长,HBs Ag阳性率呈上升趋势。同时,在调查对象中,乙肝感染主要集中在25~35岁,感染率均>2.0%;④农村产妇HBs Ag阳性率均明显高于城镇产妇;⑤2015-2017年县医院首针接种率和及时率均高于全县水平,其中影响县医院首针接种及时率的原因主要是早产及体重过轻。结论安溪县医院2015-2017年产妇HBs Ag阳性率较高,应加强孕妇产前HBs Ag筛查和管理,完善新生儿首诊乙肝疫苗及时接种工作体系管理,切实提高母婴乙肝阻断效果。

2020年西藏自治区1~14岁儿童乙型肝炎流行病学调查分析

目的:了解2020年西藏自治区1~14岁儿童乙型肝炎血清标志物流行情况和乙型肝炎疫苗接种情况。方法:使用2020年全国乙型肝炎血清流行病学调查资料,分析西藏自治区1~14岁儿童乙型肝炎表面抗原、表面抗体和核心抗体阳性率、乙型肝炎疫苗接种情况。结果:共调查1059人,其中乙型肝炎表面抗原、表面抗体、核心抗体阳性率分别为2.64%、39.47%、5.67%,乙型肝炎疫苗接种率、全程接种率、首针及时接种率分别为96.51%、93.48%、76.86%。1~4岁、5~9岁、10~14岁儿童乙型肝炎表面抗原阳性率分别为2.23%、2.31%、3.72%;表面抗体阳性率分别为52.79%、36.57%、26.39%;核心抗体阳性率分别为4.19%、6.25%、6.69%。结论:2020年西藏自治区1~14岁儿童乙型肝炎表面抗原阳性率较既往下降,乙型肝炎疫苗接种率水平较高,需重点推进乙型肝炎疫苗首针及时接种工作。

铜陵市1318名体检人员乙型肝炎病毒感染情况及疫苗接种率调查

目的对铜陵市1318名体检人员乙型肝炎病毒(HBV)感染情况及疫苗接种率进行调查分析。方法随机抽取铜陵市人民医院2023年1月至2023年12月体检中心接收的体检人员共计1318名,采用酶联免疫吸附法检测HBV表面抗原(HBsAg)、HBV表面抗体(HBsAb)、HBV核心抗体(HBcAb),采用问卷调查乙肝疫苗(HepB)接种率。结果1318名体检人员中,HBsAg阳性率为1.82%(24/1318),HBsAb阳性率为59.03%(778/1318),HBcAb阳性率为0.61%(8/1318),HBV感染率为0.76%(10/1318),HepB接种率为98.25%(1210/1318);1~4岁、5~14岁、15~29岁、30~69年龄组的HepB接种率为99.36%、98.61%、64.81%、39.57%,HBsAg阳性率为0.00%、0.35%、1.85%、2.98%;HBsAb阳性率为88.46%、76.04%、60.00%、42.88%;HBcAb阳性率为2.56%、3.82%、15.56%、30.46%,差异均有统计学意义(Z=12.644,3.067,2.103,10.495,10.806,P<0.05);城镇人群HBsAg阳性率低于农村人群,HBsAb阳性率及HepB接种率均高于农村人群,差异有统计学意义(χ^(2)=5.632,8.685,6.783,P<0.05);在有、无HepB免疫史及HepB免疫史不详的群体中,有HepB免疫史的群体HBsAg阳性率最低,HBsAb阳性率最高,差异有统计学意义(Z=3.722,3.081,P<0.05);经多因素Logistics回归得出有乙肝家族史、拔牙史及侵入性诊疗史均是影响HBV发生的独立危险因素(OR=1.781,1.793,1.784,P<0.05)。结论铜陵市1318名体检人员HBsAg阳性率携带率低,需注意重点扫描有拔牙史、乙肝家族史及侵入性诊疗史人群并加强HepB预防接种,以进一步提高铜陵市全体人民免疫水平。

不同成人乙肝疫苗接种程度对免疫效果的影响观察

目的观察不同成人乙肝疫苗接种程度对免疫效果的影响。方法从2021年3月—2022年4月在某医院注射成人乙肝疫苗服务对象中,抽取120例作为研究样本,以免疫注射程序为分组依据,将所有患者平均分为研究组和对照组,研究组接受0-1-6程序接种,对照组接受0-1-3程序接种,每组60例。120例患者接种的疫苗均为重组酵母乙肝疫苗,注射剂量是20μg,分别评价完成免疫注射后1个月、6个月、12个月的效果,同时记录不良反应发生情况。结果完成免疫注射后的1个月时,两组患者在抗-HBs、抗-HBc阳性率上的差异无统计学意义(P>0.05);免疫注射6个月、12个月时,研究组的抗-HBs与抗HBc阳性率均高于对照组,组间差异有统计学意义(P<0.05);两组患者均没有不良反应发生。结论注射乙肝疫苗时,采取0-1-6免疫注射程序的效果更佳,安全性能够得到更好保障,具有极高推广应用价值。

边远地区乙肝疫苗首针及时接种率干预效果分析

目的探索甘肃省农村边远地区提高乙肝疫苗首针及时接种率的主要影响因素及有效的对策。方法选择乙肝疫苗接种率较低的定西市渭源县、岷县及庆阳市宁县、合水县的8个乡镇32个行政村，抽取其中2003年1月1日-2005年2月28日期间出生的儿童1107名，进行乙肝疫苗接种率、未接种或未及时接种的原因等问卷调查，从中选取821名儿童家长、卫生院妇产科医生和乡村医生261名，开展乙肝疫苗接种知识宣传教育和专业培训等干预措施。分析影响乙肝疫苗接种率和首针及时接种率影响因素，评价干预措施效果。结果采取干预措施后，乙肝疫苗首针接种率和首针及时接种率由干预措施前的93．93％，44．75％提高到94．02％，77．17％。乡和村2级医务人员的乙肝防治知识知晓率由43．85％提高到87．79％；儿童家长知晓率由52．84％提高到91．35％，差异均有统计学意义。结论采取社会宣传动员和基层医务人员乙肝知识培训是提高边远地区乙肝疫苗首针及时接种率的有效干预措施。

江苏省一般人群乙型肝炎表面抗原阳性率与乙肝疫苗免疫的关系

目的:调查分析江苏省3个县一般人群乙型肝炎表面抗原阳性率和乙型肝炎疫苗免疫接种史的关系,为采取针对性干预措施,提高乙型肝炎综合防治水平提供依据。方法:采用分地区整群随机抽样方法确定调查对象,开展问卷调查,采集静脉血,检测乙型肝炎表面抗原(HBsAg)。结果:张家港、丹阳和泰兴的HBsAg阳性率按全国人口构成标化后分别为4.61%、6.88%和10.06%,18岁以上计划免疫前出生人群HBsAg阳性率均显著高于18岁以下计划免疫后出生人群。张家港、丹阳和泰兴3个县中18岁以上年龄组接种乙型肝炎疫苗人群的HBsAg阳性率均明显低于未接种乙肝疫苗人群。结论:张家港、丹阳和泰兴的乙型肝炎疫苗纳入儿童计划免疫已显成效,儿童组HBsAg阳性率明显降低,成人乙型肝炎疫苗接种也可获得明显效果,应提高成人疫苗接种率,以期降低该人群HBsAg阳性率。