World Hepatitis Day: What the data reveal about global gaps in immunization

An estimated 254 million people (approximately 3 in 100) lived with chronic hepatitis B in 2022, a virus which causes inflammation of the liver and can lead to severe liver disease and liver cancer. Despite the disease being preventable and treatable, an estimated 1.1 million people died from hepatitis B in 2022 alone. 

Indonesia (17.5 million), Nigeria (14.4 million), and the Philippines (5.7 million) have the highest numbers of people living with a chronic form of the disease. Many people with chronic hepatitis B don’t have symptoms and don’t know they are infected. Moreover, symptoms (such as fever, joint/muscle pain, loss of appetite, nausea, and jaundice) may be similar to those of an acute infection.

Vaccines are a safe and effective tool to prevent people from contracting the disease. The following two visuals showcase hepatitis B3 vaccination data:  the percentage of children ages 12-23 months who received hepatitis B vaccinations before 12 months or at any time before the survey.  WHO recommends that infants receive three doses (HepB3) of hepatitis vaccines because the first two doses provide partial “base” immunity, while the third dose “locks in” long-term immunity. The risk of chronic hepatitis B is age-dependent: it occurs in under 5% of adult infections but in approximately 95% of infections acquired during infancy or early childhood. This is the primary reason why infant and childhood vaccination are so vital. The indicator is an important metric for assessing adequate vaccination coverage among infants. 

Since 2000, all regions have seen an increase in hepatitis B3 immunizations. In South Asia immunizations have increased by more than 90 percentage points and in Sub-Saharan Africa by more than 65 percentage points. Vaccination rates increased markedly from 2000 to 2010 across the globe, but progress has since slowed down.

In recent years, immunization coverage has declined in East Asia, Latin America & Caribbean, and in low-income economies around the world.  During the COVID-19 pandemic, there was a decrease in routine childhood vaccination, caused by numerous factors, primarily the strain on public health resources, supply-chain disruptions, and stay-at-home orders. Other barriers to vaccination include lack of education and awareness, cultural obstacles, and cost and availability of the vaccine. Availability is a major obstacle, especially when it comes to home births:  infants born at home in poor or remote areas may not have access to healthcare and vaccines. As a result, the risk of hepatitis B transmission persists. Each year, over 1 million people become infected with the disease.

While HepB3 immunization rates have increased substantially in the 21st century, it is essential that these efforts continue. This will require expanding access to healthcare for low-income populations, especially those living in rural areas.

Source : World Bank