Epidemiologic Reviews Advance Access published online on June 16, 2006
Epidemiologic Reviews, doi:10.1093/epirev/mxj010
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1 Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
* To whom correspondence should be addressed. The national hepatitis B vaccination program in Taiwan is considered one of the most successful and effective public health programs to control chronic hepatitis B infection in the past 20 years. This review illustrates how to implement a successful hepatitis B vaccination program based on Taiwan's experience. Several important controlled randomized clinical trials on hepatitis B immunoglobulin and vaccine in Taiwan demonstrated an 80-90% protective effect among infants of mothers who were positive for either hepatitis B envelope antigen or hepatitis B surface antigen. A series of prevalence surveys on children born before and after the national vaccination program began disclosed a steady decrease in seroprevalence of hepatitis B surface antigen in Taiwan, with 78-87% effectiveness after the national vaccination program was launched. Studies on the secular trend of liver disease risk also documented a 68% decline in mortality from fulminant hepatitis in infants and a 75% decrease in the incidence of hepatocellular carcinoma in children 6-9 years of age after the national vaccination program began. In conclusion, since 1984, the national hepatitis B vaccination program has been successful in preventing acute and chronic liver diseases in Taiwan.
Accepted April 6, 2006
Article
Nationwide Hepatitis B Vaccination Program in Taiwan: Effectiveness in the 20 Years After It Was Launched
Yin-Chu Chien 1,
Chyi-Feng Jan 2,
Hsu-Sung Kuo 3,
and
Chien-Jen Chen 4 *
2 Department of Family Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
3 Center for Disease Control, Taiwan, Republic of China
4 Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan; Genomics Research Center, Academia Sinica, Taipei, Taiwan
Chien-Jen Chen, E-mail: cjchen{at}ha.mc.ntu.edu.tw
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