Control of hepatitis B virus infection by vaccination: the Taiwan experience

Hepatitis B virus infection poses a serious health problem in Taiwan, and plays an important role in the development of chronic hepatitis, liver cirrhosis and hepatoma; the latter two are among the 10 leading causes of death in Taiwan. The success from a mass hepatitis B vaccination program, which began in 1984 and first included high-risk neonates, has seen the hepatitis B carrier rate among children in Taiwan drop from 10% to less than 2%, and the annual incidence of childhood hepatoma has also decreased significantly in recent years. Prior to this vaccination program, a series of viral epidemiologic surveys, transmission pattern studies and pilot immunization trials proved the clinical, economic and strategic benefits of mass immunization and provided the impetus for the Taiwan government to implement a mass vaccination program. This is one of the most remarkable success stories in the field of public health.