Infant immunization in Europe

To quote others here... "This will shock you!"

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2586

"Introducing universal hepatitis B vaccination in Europe: differences still remain between countries"

Concerning the reports cited here recently that infant and childhood immunization rates are somehow correlated to the higher infant mortality rates in the United States when compared to certain European countries (post hoc ergo propter hoc)...

Eurosurveillance (Europe's journal on infectious disease epidemiology, prevention and control) reported about the progress of the World Health Assembly's 1992 recommendation to add universal Hepatitis B immunization to the schedule of immunizations for infants and/or adolescents.

Hepatitis B is the earliest immunization given to infants. IF there's any correlation with infant mortality in European countries, why isn't it reflected in Europe's lower infant mortality rates?

It's interesting to note that some of the northern European countries do not routinely administer the HepB immunization because because of a RISK factor. NOT A RISK FROM THE VACCINE, it's because:

"In some very low endemic countries in western Europe, where the HBsAg carrier rate is under 0.5%, hepatitis B is viewed as a limited public health problem that for the moment does not justify additional expenses on the health care budget. The United Kingdom, Ireland, the Netherlands, and the Nordic countries choose to provide hepatitis B vaccines only to well-defined risk groups, in addition to screening pregnant women to identify and vaccinate exposed newborns."

More quotes from the publication:

"The increased availability of a safe and effective hepatitis B vaccine makes control and ultimate elimination of hepatitis B infection and associated diseases a real possibility. The next decade will be characterised by expanded use of hepatitis B vaccines, monovalent as well as combined, and increasing efforts to sustain vaccine programmes."

"However, a crucial element for all countries in reaching or failing to reach the 1997 WHO targets is the social and political commitment to prevent hepatitis B in their future generations."

"Therefore, any realistic attempt to eliminate HBV will require reconsideration of earlier, less effective vaccination strategies and international cooperation on a global scale. Only by doing so will we come closer to the WHO goal and prevent millions of unnecessary deaths and suffering."

"The results of effective implementation of universal hepatitis B programmes have become apparent in terms of reduction not only in incidence of acute hepatitis B infections, but also in the carrier rate in immunised cohorts, and in hepatitis B related mortality."

Everyone seems to love references here:

1.World Health Organization. Expanded Programme on Immunisation Global Advisory Group. Wkly Epidemiol Rec 1992; 3: 11-16.

2.Van Damme P, Kane M, Meheus A. Integration of hepatitis B vaccination into national immunisation programmes. BMJ 1997; 314: 1033-7.
http://bmj.bmjjournals.com/cgi/content/full/314/7086/1033

3.Coursaget P, Leboulleux D, Soumare M, Le Cann P, Yvonnet B, Chiron JP, et al. Twelve-year follow-up study of hepatitis B immunisation of Senegalese infants. J Hepatol 1994; 21(2): 250-4.

4.Whittle HC, Maine N, Pilkington J, Mendy M, Fortuin M, Bunn J, et al. Long-term efficacy of continuing hepatitis B vaccination in infancy in two Gambian villages. Lancet 1995; 345: 1089-92.

5.Chang MH, Chen CJ, Lai MS, Hsu HM, Wu TC, Kong MS, et al. Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. Taiwan Childhood Hepatoma Study Group. N Engl J Med 1997; 336(26):1855-9.

6.Wainwright R, Bulkow LR, Parkinson AJ, Zanis C, McMahon BJ. Protection provided by hepatitis B vaccine in a Yupik Eskimo Population: results of a 10 year study. J Infect Dis 1997; 175: 674-7.

7.Bonanni P, Crovari P. Success stories in the implementation of universal hepatitis B vaccination: an update on Italy. Vaccine 1998; 16 (suppl): S38-S42.

8.Stroffolini T, Mele A, Tosti ME, Gallo G, Balocchini E, Ragni P, et al. The impact of the hepatitis B mass immunisation campaign on the incidence and risk factors of acute hepatitis B in Italy. J Hepatol 2000; 33: 980-5.

9.EUROHEP.NET. Data on surveillance and prevention of hepatitis A and B in 22 countries, 1990-2001. Antwerp: EUROHEP.NET; 2004.
also available at http://www.eurohep.net

10.Romano L, Mele A, Pariani E, Zappa A, Zanetti A. Update in the universal vaccination against hepatitis B in Italy : 12 years after its implementation. Eur J Public Health 2004; 14 (suppl): S19.

11.Viral Hepatitis Prevention Board. Hepatitis B vaccination: how to reach risk groups? Viral Hepatitis 2001; 10(1): 8-10.
http://www.vhpb.org/files/html/Meetings_and_publications/Viral_Hepatitis_News...

12.Viral Hepatitis Prevention Board. Prevention of viral hepatitis in the Nordic countries. Viral Hepatitis 2004; 12(3): 2-8. http://www.vhpb.org/files/html/Meetings_and_publications/Viral_Hepatitis_News...

13.FitzSimons D, Van Damme P, Emiroglu N, Godal T, Kane M, Malyavin A, et al. Strengthening immunization systems and introduction of hepatitis B vaccine in Central and Eastern Europe and the Newly Independent States (Meeting report). Antwerp: Viral Hepatitis Prevention Board; 2002.

14.Beeching NJ. Hepatitis B infections. Universal immunisation should be preferred in Britain. BMJ 2004; 329: 1059-60. http://bmj.bmjjournals.com/cgi/content/full/329/7474/1059

15.Koppelman M, Zaaijer H. Diversity and origin of hepatitis B virus in Dutch blood donors. J Med Virol 2004; 73: 29-32.

16.Shouval D. Is universal vaccination against hepatitis B sufficient for control of HBV infection? Lessons from the immunization campaign in Italy (Editorial). J Hepatol 2000; 33: 1009-11.
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