5 Points on Hepatitis B Virus in India

1. Morbidity and Mortality Statistics: Despite the introduction of hepatitis B vaccine in the Universal Immunisation Programme in 2002 and scaling-up nationwide in 2011, about one million people in India become chronically infected with the virus every year. According to the Health Ministry, as on February 2019, an estimated 40 million people in India were infected. Hepatitis B infection at a young age turns chronic, causing over 1,00,000 premature deaths annually from liver cirrhosis or liver cancer.
2. Vaccination Coverage Increased; Disease Uncontrolled: According to the WHO, the coverage of hepatitis B third dose had reached 86% in 2015. However, despite the high vaccination coverage, disease prevalence in children aged less than five years has not dropped below 1%.
3. First 24 Hour Period Crucial: One of the reasons for this is the sub-optimal coverage of birth dose in all infants within 24 hours of birth. Even seven years after the Health Ministry approved the birth dose in 2008, its coverage remained low — 45% in 2015 and 60% in 2016 — according to a 2019 Health Ministry report.
4. Awareness and Training of Health Workers: One of the reasons for the low coverage is the fear of wastage of vaccine when a 10-dose vial is used. Unfortunately, health-care workers are very often unaware of the WHO recommendation that allows hepatitis B open-vial policy. Opened vials of hepatitis B vaccine can be kept for a maximum duration of 28 days for use in other children if the vaccine meets certain conditions.
5. Conclusion: Awareness and Achievement: There is also a need to increase public awareness about the merits of the birth dose. On September 3, 2019, Bangladesh, Bhutan, Nepal and Thailand became the first four countries in the World Health Organization’s southeast Asia region to have successfully controlled hepatitis B. India must follow suit.