Low Hepatitis B Immunity Among Ukrainian Refugee Children and Adolescents in Poland: Need for Targeted Screening and
Lidia Stopyra1,2, Karolina Banach1,2, Magdalena Wood2
1Department of Infectious and Tropical Diseases, Andrzej Frycz Modrzewski Krakow University Medical College, 30-705 Kraków, Poland.
Insights
Ukrainian refugee children in Poland show a significant hepatitis B immunity gap, especially adolescents. This highlights the need for targeted hepatitis B virus (HBV) screening and catch-up vaccination strategies.
Area of Science:
- Pediatric Infectious Diseases
- Public Health
- Immunology
Background:
- The 2022 conflict in Ukraine led to mass migration, with many Ukrainian children entering Poland.
- Ukraine has inconsistent hepatitis B vaccination coverage, contrasting with Poland's high rates.
- This influx raises concerns about hepatitis B virus (HBV) immunity in refugee children.
Purpose of the Study:
- To assess hepatitis B immunity and infection prevalence in Ukrainian refugee children in Southern Poland.
- To evaluate the implications for Poland's vaccination strategies.
Main Methods:
- A prospective cross-sectional study of 1322 Ukrainian refugee children (0-18 years) in Southern Poland (Feb 2022-Mar 2024).
- Collected data on vaccination history, demographics, and hepatitis B markers (HBsAg, anti-HBs).
- Protective immunity defined as anti-HBs ≥10 IU/L.
Main Results:
- 83.2% reported vaccination, but only 64.9% had protective anti-HBs levels.
- Immunity significantly decreased with age; <50% of 15-18 year olds were immune.
- Five children (0.4%) had chronic hepatitis B; four were unvaccinated.
Conclusions:
- A substantial hepatitis B immunity gap exists among Ukrainian adolescent refugees in Poland.
- The findings underscore the need for enhanced surveillance, screening, and catch-up HBV vaccination programs.
- Addressing this immunity gap is crucial given the risk of HBV transmission in adolescents.
Background:
The 2022 conflict in Ukraine triggered mass migration, leading to a significant influx of Ukrainian refugee children into Poland. This situation raises concerns about hepatitis B virus immunity, as Ukraine's hepatitis B vaccination coverage has been inconsistent compared to Poland's high vaccination rates.
Objective:
To evaluate hepatitis B immunity and infection prevalence among Ukrainian refugee children residing in Southern Poland and to assess implications for vaccination strategies in the host country.
Methods:
A prospective cross-sectional study was conducted on 1322 Ukrainian refugee children (0-18 years) presenting to a pediatric infectious diseases department in Southern Poland between February 2022 and March 2024. Data on vaccination history, demographic characteristics, and selected laboratory parameters, including hepatitis B surface antigen and anti-HBs antibody levels, were collected. Protective immunity was defined as anti-HBs antibody levels ≥10 IU/L.
Results:
Among the participants (mean age 9.9 years; 50.2% female), 83.2% were reported as vaccinated according to national immunization programs, but only 64.9% demonstrated protective anti-HBs antibody levels. Protective antibody prevalence declined significantly with age, with less than half of adolescents aged 15-18 years showing immunity. Five children (0.4%) were diagnosed with chronic hepatitis B, four of whom were unvaccinated.
Conclusions:
This study identifies a significant gap in hepatitis B immunity among Ukrainian adolescent refugees residing in Southern Poland, with less than half possessing protective anti-HBs antibody levels. This immunity gap and the high risk of sexual transmission of the hepatitis B virus in adolescents highlight the urgent need for comprehensive surveillance, screening, and catch-up vaccination programs.
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