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People without effective immunization are vulnerable to infection with hepatitis B virus (HBV). At present, there is no appropriate hepatitis B vaccination strategy for HBV-susceptible adults. We aim to assess the long-term effect of neonatal hepatitis B immunization and HBV markers among college students, so as to explore hepatitis B vaccination strategies suitable for high-risk group. The enrolled freshmen from four universities were initially tested for hepatitis B screening using colloidal gold test strips. Subjects with positive hepatitis B surface antigen (HBsAg) or negative hepatitis B surface antibody (anti-HBs) were further confirmed using Abbott reagents. HBsAg and anti-HBs double negative individuals were administered hepatitis B vaccination. Using Abbott reagents, we confirmed that among 3242 enrolled freshmen, 1604 (49.5 %) were negative for both HBsAg and anti-HBs, and 27 (0.8 %) were HBsAg-positive. Among the double negative freshmen, 1263 received hepatitis B vaccination. After the first and second dose of hepatitis B vaccine, the protective anti-HBs seroconversion rates reached 91.4 % and 98.5 %, respectively. Only one (0.1 %) freshman was still negative for anti-HBs after the third dose of hepatitis B vaccine. In addition, 96.3 % (104/108) of the fresmen who failed to achieve protective anti-HBs seroconversion after the first dose of hepatitis B vaccine had a baseline anti-HBs level < 2 mIU/mL. The HBsAg prevalence among college students has been significantly reduced after the integration of hepatitis B vaccine into Expanded Program on Immunization, but the rate of seroprotective anti-HBs among these students remains low. Hepatitis B vaccination or booster dose is advised for a high-risk group who have negative anti-HBs, and two doses of hepatitis B vaccine are advised for those with anti-HBs < 2 mIU/mL.

Belarus conducted a representative, national hepatitis B serosurvey to evaluate the impact of hepatitis B vaccination programme. We used a multi-stage cluster design to select 3783 children born between 2009 and 2015. We collected demographic and immunization data, as well as venous blood samples, which were analysed for HBsAg by ELISA. Out of 2870 participants with valid test results, one tested positive for HBsAg, resulting in a weighted seroprevalence of 0.02% (one-sided 95% upper bound = 0.09%). Of the 3731/3783 (99%) participants with immunization records, 86.8% (95% CI: 84.8; 88.6) had received a timely birth dose of hepatitis B vaccine and 85.6% (95% CI: 83.5; 87.4) had received a birth dose and at least two subsequent doses of the vaccine. This study findings demonstrated the achievement of the regional hepatitis B control targets and significant progress toward the elimination of hepatitis B as a public health threat in Belarus. •Representative hepatitis B serosurvey evaluated impact of vaccination in Belarus.•Vaccination programme reduced hepatitis B prevalence in children to 0.02%.•Post-vaccination hepatitis B prevalence in a country of the WHO European Region.

This study aimed to evaluate the impact of Thailand’s hepatitis B virus (HBV) National Program Immunization (NPI), 32 years post-implementation, on infection rates and immunity in various age groups. A cross-sectional study involved 6,068 participants aged 6 months to 80 years from four regions in Thailand. Blood samples were tested for HBsAg, anti-HBs, and anti-HBc using a chemiluminescent immunoassay. Data were compared across age groups and with previous surveys from 2004 to 2014. Individuals born after the implementation of the NPI had significantly lower HBV infection rates ( p  < 0.0001). No HBsAg was detected in individuals under 20 years old. The prevalence of HBV carriers increased with age, from 0.3% in the 21–30 group to 4.3% in those over 60, with an overall prevalence of 1.7%. Percentages of seroprotected individuals (anti-HBs ≥ 10 mIU/mL) were high in young children but dropped to 19.4% in ages 11–20 and 12.5% in ages 21–30. Anti-HBc was found at very low rates in children but increased significantly after age 30. Thailand’s HBV NPI significantly reduced HBV infection rates, especially in younger populations. This study highlighted the program’s success and guided future elimination efforts to achieve hepatitis elimination goal by 2030.

Uzbekistan, a highly endemic country for hepatitis B virus (HBV), introduced infant vaccination with hepatitis B vaccine (HepB) in 2001. Since 2002, it had ≥90 % reported immunization coverage for ≥3 doses of HepB (HepB3) and the birth dose (HepB-BD). However, the impact of HepB vaccination and the progress towards achieving the regional hepatitis B control and global viral hepatitis B elimination goals had not been assessed. To determine current HBsAg prevalence among children in Uzbekistan, in 2022, we conducted a nationwide serosurvey among schoolchildren (grades 1–3) using a stratified, multi-stage cluster design. Participants' basic demographics and HepB immunization information were obtained. Blood specimens were tested for HBsAg using a WHO-prequalified rapid test (Bioline HBsAg WB, Abbott Diagnostics). Samples with positive and indeterminate results were tested for HBsAg by ELISA (Murex HBsAg Version3, Diasorine). Weighted proportions and adjusted 95 % confidence intervals (CI) were calculated. Of 4119 children enrolled in 148 schools, blood was collected from 3753 (91.1 %) and immunization data were available for 3833 (93.3 %). National HBsAg prevalence was 0.20 % (adjusted 95 % CI, 0.09 %–0.38 %). Among children with available immunization data, 97.7 % (97.2 %–98.1 %) received ≥3 HepB doses and 94.9 % (94.1 %–95.5 %) received HepB-BD, including timely HepB-BD in 93.7 % (92.9 %–94.5 %). The survey demonstrated that Uzbekistan has met the <0.5 % European regional HBsAg seroprevalence target and has made substantial progress towards meeting the <0.1 % HBsAg seroprevalence target for the elimination of HBV mother to-child transmission (MTCT). Based on these findings and ≥ 90 % HepB-BD and HepB3 coverage, in 2023, Uzbekistan was validated as having achieved the regional hepatitis B control goal. To achieve the elimination of MTCT of HBV, additional interventions, including improving antenatal screening for HBsAg, providing antiviral treatment of eligible HBsAg-positive pregnant women and hepatitis B immunoglobulin to infants born to HBsAg-positive mothers, should be considered. •Historically, hepatitis B virus (HBV) infection was very common in Uzbekistan.•Infant hepatitis B vaccination was introduced in Uzbekistan in 2001.•Serosurvey among children to assess the impact of vaccination was conducted in 2022.•Among children, prevalence of HBsAg – a marker of chronic HBV infection, was 0.2 %.•Uzbekistan has met the European Regional target of <0.5 % HBsAg prevalence among children.

Hepatitis B virus vaccination is currently recommended in Australia for adults at an increased risk of acquiring infection or at high risk of complications from infection. This retrospective cohort study used data from an Australian sentinel surveillance system to assess the proportion of individuals who had a recorded test that indicated being susceptible to hepatitis B infection in six priority populations, as well as the proportion who were then subsequently vaccinated within six months of being identified as susceptible. Priority populations included in this analysis were people born overseas in a hepatitis B endemic country, people living with HIV, people with a recent hepatitis C infection, gay, bisexual and other men who have sex with men, people who have ever injected drugs, and sex workers. Results of the study found that in the overall cohort of 43,335 individuals, 14,140 (33%) were identified as susceptible to hepatitis B, and 5,255 (37%) were subsequently vaccinated. Between 26% and 33% of individuals from priority populations were identified as susceptible to hepatitis B infection, and the proportion of these subsequently vaccinated within six months was between 28% and 42% across the groups. These findings suggest further efforts are needed to increase the identification and subsequent vaccination of susceptible individuals among priority populations recommended for hepatitis B vaccination, including among people who are already engaged in hepatitis B care.

To evaluate the long-term efficacy and anamnestic response of Chinese hamster ovary (CHO) cell-derived hepatitis B vaccine (CHO-HepB) after 18–20 years, a cross-sectional survey was conducted in seven communities in Zhengding County at the end of 2017. The birth cohort 1997–1999 vaccinated primarily with three doses of CHO-HepB were enrolled in the survey. The HBV serological markers were quantified using the Chemiluminescence method. The infection status of HBsAg-positive participants was determined by comparing their results with the previous data. For those with an anti-HBs antibody negative, the anamnestic response was evaluated by measuring anti-HBs antibody concentrations following a dose of HepB administration. A total of 1352 participants were enrolled, with the prevalence of HBsAg, anti-HBs, and anti-HBc being 0.4 %, 74.5 %, and 1.3 %, respectively. There was no significant difference in the HBV markers (HBsAg, anti-HBs and anti-HBc) between birth-year groups (P > 0.05). The geometric mean concentration (GMC) of anti-HBs antibodies among 1007 positive participants was 191 mIU/ml. No new infections or carriers were identified in the survey. Combined with the three previous surveys of the same birth cohort, the positive rates of HBsAg, anti-HBs, and anti-HBc remained largely unchanged over two decades following CHO-HepB vaccination. Of 248 participants who received a booster vaccination, 231 (93.1 %) showed an anti-HBs antibody positive with a GMC of 369 mIU/mL. Moreover, the positive rate and GMC of anti-HBs were higher in the CHO-HepB booster group compared to the Saccharomyces cerevisiae-HepB booster group. The long-term efficacy of the CHO-HepB remains stable for 18–20 years after primary vaccination, and a higher seroconversion rate of anti-HBs is observed following a booster vaccination of CHO-HepB. Given the absence of new infections or carriers over the past two decades, it appears unnecessary to administer a booster vaccination of HepB. •The positive rate for anti-HBs was 74.5 % after 18–20 years following CHO-HepB vaccination, with a geometric mean concentration (GMC) of 191 mIU/mL.•The prevalence of HBsAg and anti-HBc were 0.4 % and 1.3 %, respectively, without new infections or carriers identified.•The positive rates for HBsAg, anti-HBs, and anti-HBc have remained largely stable over the two decades since CHO-HepB vaccination.•Following a booster HepB vaccination, 93.1 % of participants exhibited anti-HBs antibody levels above 10 mIU/mL, with a GMC of 369 mIU/mL.

Background Hepatitis B (HepB) is a major public health concern in Malaysia yet little is known about knowledge and awareness of this infection in the country. Such information is essential for designing effective intervention strategies for HepB prevention and control. The aim of this study was to characterize knowledge and awareness regarding HepB in Malaysia and to identify their associated sociodemographic determinants. Methods A community-based cross-sectional survey was conducted between January and May 2016 in Selangor state of Malaysia. A two-stage cluster random sampling design was used and one adult member of selected households was interviewed face-to-face. Logistic regression was used to estimate the differences in knowledge and awareness between groups. Results A total of 764 households completed the interviews and were included in the final analysis. Only 36.9 and 38.8% of the participants had good knowledge and awareness, respectively. The factors associated with good knowledge were being in the 35–44 year age group, Malay ethnicity, high educational attainment and high family income. Being Chinese, being older and having high educational attainment were determinants of having good awareness towards HepB. Participants who had good knowledge were 2.5 times more likely to also have good awareness (OR: 2.41, 95% CI: 1.78–3.26, p  < 0.001). Conclusions This study reveals a low level of knowledge and awareness of HepB among households in Malaysia. This finding highlights the need to improve public knowledge and awareness through well-designed programs targeting vulnerable groups in order to reduce hepatitis B virus transmission and achieve the governmental target of eliminating viral hepatitis as a public health concern by 2030.

Introduction Eliminating Hepatitis B by 2030 is achievable through vaccination. However, despite the safety of the Hepatitis B vaccine, vaccination coverage among adults in India is suboptimal. Methods From April 2021 to August 2022, a study in New Delhi, India assessed Hepatitis B vaccination status, willingness to be vaccinated, and awareness of vaccination importance among adults. Results 7,097 participants (mean age  ±  SD = 43.3  ±  14 years; range = 18–99 years) were screened. 93.3% of participants reported not receiving even a single dose of the Hepatitis B vaccine. Only 4.4% of the participants were completely vaccinated for Hepatitis B. On Binomial Logistic Regression, we found that as the age increase [Exp(b) = 4.09; 95% CI = 2.061–8.148; p  < 0.001], females [Exp(b) = 1.327; 95% CI = 1.056–1.667; p  = 0.015], married [Exp(b) = 5.891; 95% CI = 4.610–7.528; p  < 0.001], illiterate [Exp(b) = 30.085; 95% CI = 13.307–68.020; p  < 0.001], employed [Exp(b) = 1.966; 95% CI = 1.471–2.629; p  < 0.001], Muslim population [Exp(b) = 3.031; 95% CI = 1.552–5.917; p  = 0.001], monthly salary < 10,000 INR [Exp(b) = 9.580; 95% CI = 6.172–14.872; p  < 0.001] are significantly less likely to have completed Hepatitis B vaccination. Most respondents (85.5%) were willing to receive Hepatitis B vaccination, whereas only 25% knew that Hepatitis B vaccination was an effective way to prevent and control Hepatitis B. Conclusion Targeted policies and programs are needed to improve low vaccination rates among older adults in India. The Advisory Committee on Immunization Practices recommends Universal Adult Hepatitis B vaccination, which can eliminate the need for risk factor screening, increase vaccination coverage, and reduce Hepatitis B cases.

•Prevalence of hepatitis B infection markers among children in Ukraine was uncertain.•We found low prevalence of hepatitis B infection among children across survey sites.•Zakarpattya (0.7% HBsAg-positive) was the only site above the 0.5% WHO/EURO target.•Hepatitis B vaccination status across all survey sites was suboptimal.•Large numbers of children at risk of future hepatitis B infection unless vaccinated.•Coverage should be increased to further reduce hepatitis B transmission in Ukraine. Before hepatitis B vaccine (HepB) introduction, level of endemicity of hepatitis B virus (HBV) in Ukraine was estimated as intermediate but the prevalence of HBV infection markers has not been measured in population-based serosurveys. Coverage with 3 doses of HepB, introduced in 2002, was 92%-98% during 2004–2007 but declined to 21%-48% during 2010–2016. To obtain data on HBV prevalence among children born after HepB introduction, we tested specimens from a serosurvey conducted in Ukraine in 2017, following circulating vaccine-derived poliovirus outbreak in 2015, among birth cohorts eligible for polio immunization response. The serosurvey was conducted in Zakarpattya, Sumy, and Odessa provinces, and Kyiv City, targeting 2006–2015 birth cohorts. One-stage cluster sampling in the provinces and stratified simple random sampling in Kyiv were used for participant selection. All participants were tested for antibodies against HBV core antigen (anti-HBc). Anti-HBc-positive children were tested for HBV surface antigen (HBsAg). We also obtained information on HepB vaccination status for all children. Of 4,596 children tested, 81 (1.8%) were anti-HBc-positive and eight (0.2%) were HBsAg-positive. HBsAg prevalence was 0.7% (95% confidence interval, 0.3%-1.4%) in Zakarpattya, 0.1% (0.0%-0.4%) in Sumy, 0% (0.0%-03%) in Odessa, and 0.1% (0.0%-0.8%) in Kyiv. Across survey sites, the proportion of recipients of ≥ 3 HepB doses was 53%-80% in the 2006–2009 cohort and 28%-59% in the 2010–2015 cohort. HBV prevalence among children in surveyed regions of Ukraine in 2017 was low, including in Zakarpattya—the only site above the 0.5% European Regional target for HBsAg seroprevalence. However, HepB vaccination was suboptimal, particularly among children born after 2009, resulting in large numbers of unvaccinated or incompletely vaccinated children at risk of future HBV infection. HepB coverage should be increased to further reduce HBV transmission among children in Ukraine and achieve regional and global hepatitis B control/elimination targets.

Background Hepatitis B virus (HBV) is associated with several acute and long-term complications and vaccination is the cornerstone of prevention. A recent outbreak in Gulu, Uganda, one of the districts covered by a mass vaccination campaign, suggests low uptake of HBV vaccination. This study aims to determine the uptake and completion of HBV vaccination and associated factors among residents of Gulu, Uganda. Methods A mixed methods cross-sectional study was conducted in Gulu, Northern Uganda, among 434 adult residents. A pretested questionnaire was used to collect data on socio-demographics, perceptions, and knowledge of HBV vaccination. Modified Poisson regression analysis was used in STATA 14 software to obtain prevalence ratios for the association between the independent and dependent variables. For qualitative data, 9 key informant interviews were conducted and thematic analysis was done using Quirkos software. Results Out of the 434 respondents, 41.9% had received at least one dose of the hepatitis B vaccine, 32.5% had received at least 2 doses, and only 20% had completed all 3 doses, with an overall completion rate of 47.8% for participants who had been initiated on the vaccine. Gender, residence, risk perception of Hepatitis B infection, perceived safety of the vaccine, and awareness of mass vaccination were associated with uptake of Hepatitis B vaccination. Residence, knowledge, and perception of being at risk of acquiring Hepatitis B were associated with completion. Qualitative results revealed that the levels of uptake and completion could have been affected by access to vaccination sites; inadequate knowledge about the disease; myths about the vaccine and inadequate community engagement. Conclusion Low Hepatitis B vaccine uptake and completion rates were observed in Gulu. To enhance vaccination coverage, future initiatives should prioritize awareness, education, and dispelling of vaccination myths. Additionally, increased government investment in training health workers can serve as a valuable strategy to improve information dissemination and awareness among the population.