2021 TDDW
Symposium (VII) TAIWAN CAN HELP – COMBAT AGAINST DIGESTIVE DISEASES ON A NATIONAL SCALE
UNIVERSAL VACCINATION TOWARD ELIMINATING HBV: A 35YEAR JOURNEY OF TAIWAN Yen-Hsuan Ni Department of Pediatrics, College of Medicine and Children’s Hospital, National Taiwan University, Taipei, Taiwan The world’s first nationwide HBV universal vaccination program for infants was launched in Taiwan in July, 1984. Though different countries provide different schedules, most programs consist of 3 doses of recombinant HBV vaccines and hepatitis B immunoglobulin (HBIG). The first dose and the HBIG should be administered within 24 hours after birth. The program now consists of prenatal maternal screening and antiviral therapy if indicated, birth dose of HBIG and a timely 3-dose vaccination, and post-vaccination monitoring. The prevalence of hepatitis B surface antigen (HBsAg) carriers declined from 9.8% to 0.5% in children in Taipei City after 35 years of universal vaccination when we did not start the high viremic maternal antiviral therapy. Can we further reduce the chronic carrier rate to 0%? We have studied that the higher the mother’s viral load, the more likely the
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newborn could acquire chronic HBV infection. The answer may be that mother-to-infant transmission cannot be over-emphasized and should be intervened if we attempt to eradicate HBV. To completely eliminate hepatitis B virus (HBV) infection worldwide, we need to achieve the following three tasks: (1) to eradicate all of the infectious sources, (2) to interrupt every transmission route, (3) to immunize every susceptible individual. We need to develop effective antiviral therapy to control all the infectious sources; we need to screen the blood bank and all the other possible transmission routes; surely the implementation of universal vaccination program is the most fundamental part to prevent against HBV. We are now at the point to do all these work and hopefully we can achieve this aforementioned goal in this decade.
