A model program for hepatitis B vaccination and education of schoolchildren in rural China
Incomplete hepatitis B virus (HBV) vaccine coverage and poor HBV-related knowledge in China leave millions of children unprotected from this life-threatening infection. To address these gaps, a pilot program for HBV education and vaccination was launched in rural China.
In 2006, public and private organizations in the US and China collaborated to provide HBV education and vaccination to 55,000 school-age children in the remote, highly HBV-endemic area of Qinghai Province. The impact of the educational program on HBV-related knowledge was evaluated among more than 2,800 elementary school students.
Between September 2006 and March 2007, the three-shot hepatitis B vaccine series was administered to 54,680 students, with a completion rate of 99.4%. From low pre-existing knowledge levels, classroom educational sessions statistically significantly increased knowledge about HBV risks, symptoms, transmission, and prevention.
This program offers an effective and sustainable model for HBV catch-up vaccination and education that can be replicated throughout China, as well as in other underserved HBV-endemic regions, as a strategy to reduce chronic HBV infection, liver failure, and liver cancer.
KeywordsHepatitis B Vaccine Education China
This project was supported by a donation from the ZeShan Foundation (Hong Kong) and by the Asian Liver Center at Stanford University through private donations. The authors thank Jordan Su for her work on coordinating this project.
- Campbell JV, Garfein RS, Thiede H, Hagan H, Ouellet LJ, Golub ET, Hudson SM, Ompad DC, Weinbaum C (2007) Convenience is the key to hepatitis A and B vaccination uptake among young adult injection drug users. Drug Alcohol Depend 91(Suppl 1):S56–63Google Scholar
- Centers for Disease Control and Prevention (CDC) (2005) A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) part 1: immunization of infants, children, and adolescents. MMWR Recomm Rep 54(RR-16):1–31Google Scholar
- Centers for Disease Control and Prevention (CDC) (2006) A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) Part II: immunization of adults. MMWR Recomm Rep 55(RR-16):1–33 quiz CE31-34Google Scholar
- Centers for Disease Control and Prevention (CDC) (2007) Progress in hepatitis B prevention through universal infant vaccination—China, 1997–2006. MMWR Morb Mortal Wkly Rep 56(18):441–445Google Scholar
- China Digital Times (2009) China news tagged with: hepatitis B. http://chinadigitaltimes.net/china/hepatitis-b/. Last updated 29 Dec 2009
- Curado MP, Edwards B, Shin HR, Storm H, Ferlay J, Heanue M, Boyle P (2007) Cancer Incidence in Five Continents, Vol. IX. IARC Scientific Publications No. 160. International Agency for Research on Cancer (IARC), LyonGoogle Scholar
- International Fund for Agricultural Development (IFAD) (2011) China: Qinghai/Hainan Prefecture Agricultural Development Project. http://www.ifad.org/lrkm/region/pi/cn_364.htm. Accessed 03/01/2011
- Juan S (2009) Hepatitis B tests for jobs set to stop. In China Daily (online). Available at: http://www.chinadaily.com.cn/china/2009-12/30/content_9244044.htm
- Juan S, Yao L (2011) Pregnant women to be tested for disease. Available at: http://www.chinadaily.com.cn/china/2011-03/01/content_12092386.htm. Last updated 1 March 2011. China Daily
- Qinghai Provincial Investment Promotion Bureau (2010) Qinghai in brief. http://www.qhszs.gov.cn/qhszs/eshengqing.asp?id=720. Last updated 31 March 2010
- The Economist (2006) Hepatitis B in China: B is for bigotry. Available at: http://www.economist.com/world/asia/displaystory.cfm?story_id=8173647
- United States Census Bureau, Population Division/International Programs Center (2010) International Data Base (IDB) Population Pyramids. http://www.census.gov/ipc/www/idb/country.php. Last updated 19 March 2010
- World Health Organization (WHO) (2007) Western Pacific regional plan for hepatitis B control through immunization. WHO Regional Office for the Western Pacific, Manila, PhilippinesGoogle Scholar
- World Health Organization (WHO) (2008a) Hepatitis B Fact Sheet No. 204. Available at: http://www.who.int/mediacentre/factsheets/fs204/en/. World Health Organization, Geneva
- World Health Organization (WHO) (2008b) World Malaria Report 2008. Annex 3B. Available at: http://apps.who.int/malaria/wmr2008/malaria2008.pdf. World Health Organization, Geneva
- World Health Organization (WHO) (2009) WHO Report 2009. Global Tuberculosis Control. Country Profile: China. Available at: http://www.who.int/tb/publications/global_report/2009/pdf/chn.pdf.4
- World Health Organization (WHO), United Nations Children’s Fund (UNICEF), Joint United Nations Programme on HIV/AIDS (UNAIDS) (2006) Epidemiological Fact Sheets on HIV/AIDS and Sexually Transmitted Infections: China. Available at: http://apps.who.int/globalatlas/predefinedReports/EFS2006/EFS_PDFs/EFS2006_CN.pdf. World Health Organization, Geneva
- Xia GL, Liu CB, Cao HL, Bi SL, Zhan MY, Su CA, Nan JH, Qi XQ (1996) Prevalence of hepatitis B and C virus infections in the general Chinese population. Results from a nationwide cross-sectional seroepidemologic study of hepatitis A, B, C, D, and E virus infections in China, 1992. Int Hepat Commn 5:62–73CrossRefGoogle Scholar
- Xinhua Economic News Service (March 5, 2009) Survey: Implicit discrimination against Chinese Hepatitis B carriers rising in multinationals Available at: http://english.peopledaily.com.cn/90001/90776/90882/6607322.html. Last updated: 05 March 2009, Last Accessed 30 March 2009