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Universal hepatitis B immunization: the British Columbia experience

A Bell1

  • 1Communicable Diseases, Epidemiology Services, BC Centre for Disease Control, Vancouver, Canada.

Vaccine
|January 1, 1995
PubMed
Summary

British Columbia implemented an expanded hepatitis B immunization program in 1992, targeting pre-adolescent children and high-risk groups to combat rising infection rates. This initiative aimed to improve vaccination coverage and control disease transmission.

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Area of Science:

  • Public Health
  • Epidemiology
  • Immunization Programs

Background:

  • Hepatitis B cases in British Columbia (BC) increased 70-fold between 1980 and 1992, significantly exceeding the national average.
  • The disease primarily affected young adults, with less than 5% of cases in individuals under 15 years old.
  • Previous targeted immunization programs for high-risk groups initiated in the mid-1980s failed to curb the rising infection rates.

Purpose of the Study:

  • To describe the implementation and initial scope of an expanded hepatitis B immunization program in British Columbia.
  • To address the increasing incidence of hepatitis B infection in the province.
  • To evaluate the effectiveness of a new, comprehensive immunization strategy.

Main Methods:

  • Implementation of a universal immunization program for grade 6 students (age 11) in schools, requiring parental consent.

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  • Broadened targeted immunization for groups identified as having an elevated risk of hepatitis B transmission.
  • Administration of a three-dose hepatitis B vaccine series by public health nurses.

    • Main Results:

    • In the 1992-1993 school year, over 42,000 grade 6 students were eligible for the hepatitis B vaccine.
    • A completion rate of 91% for the three-dose vaccine series was achieved among eligible students province-wide.
    • The program marked a significant shift towards universal vaccination for a key age cohort.

    Conclusions:

    • The expanded program represented a substantial effort to control hepatitis B in BC.
    • Universal immunization of pre-adolescents and enhanced targeting of at-risk populations were key components of the new strategy.
    • High initial uptake in the school-based component suggests feasibility for broader public health impact.