Foundation calls for universal hepatitis B vaccination in UK infants
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《英国医生杂志》
The UK government should meet demands from the World Health Organization and introduce universal vaccination against hepatitis B for infants, says the Foundation for Liver Research.
At the moment, the United Kingdom only targets high risk groups for vaccination, such as healthcare workers, men who have sex with men, sex workers, and injecting drug users. Babies of infected mothers are also vaccinated.
The foundation抯 latest report also calls for better diagnosis and treatment of the disease. Hepatitis B: Out of the Shadows cites Department of Health figures, which estimate that there are currently 180 000 people with chronic hepatitis B in the United Kingdom. Every year a further 7700 people become infected, according to the Health Protection Agency. But only 1500 patients are treated for hepatitis B each year.
"If universal and selective vaccination was implemented in the United Kingdom, as it has been in 150 other countries, this figure would be significantly reduced and the nation would be better protected," said Roger Williams, director of the foundation. The report was launched in the House of Commons this week.
"We are one of the few countries not to offer universal vaccination," said Professor Williams, "The government used to say it was not cost effective and we didn抰 have a problem, but the situation is changing."
The change has in part been due to the influx of people to the United Kingdom from countries where hepatitis B is more prevalent. And universities have been accepting more overseas students from countries such as China, where the incidence in the population is 3-4%, said Professor Williams.
Travellers abroad from the United Kingdom who had not been vaccinated but had sexual contacts while away also ran the risk of contracting the disease and bringing it back to the United Kingdom, he added.
To vaccinate all 700 000 children in the United Kingdom at birth would cost about ?1m ($38m; �30m) a year, since a course of three vaccinations costs about ?0. The initial costs of a programme to vaccinate all children less than 5 years old, however, would be about ?05m. The cost of treatment is about ?500 for someone in the late stage of the disease.
Without treatment (which includes interferon a , lamivudine, and adefovir dipivoxil) hepatitis B can eventually lead to liver cirrhosis and cancer. Professor Williams admitted that he had some involvement with the company that produces adefovir dipivoxil, although not with the companies producing the other drugs nor the manufacturer of the vaccine.
Steven Wiersma, medical officer with the World Health Organization, said the foundation抯 initiative was exciting news, "Countries with low prevalence thought they could tackle it best by other strategies, such as safe sex messages. But it抯 been shown those strategies are very hard to implement."
The United States switched from selective vaccination to universal vaccination of all infants in 1991. Holland is another exception, like the United Kingdom, which has not adopted universal vaccination.
A spokesperson for the Department of Health said that a working group of the Joint Committee on Vaccination and Immunisation was currently considering whether the current immunisation programme for hepatitis B might need to be strengthened or expanded in future. "No conclusions have been reached yet," she said, "But they should finalise their position next year."(London Lynn Eaton)
At the moment, the United Kingdom only targets high risk groups for vaccination, such as healthcare workers, men who have sex with men, sex workers, and injecting drug users. Babies of infected mothers are also vaccinated.
The foundation抯 latest report also calls for better diagnosis and treatment of the disease. Hepatitis B: Out of the Shadows cites Department of Health figures, which estimate that there are currently 180 000 people with chronic hepatitis B in the United Kingdom. Every year a further 7700 people become infected, according to the Health Protection Agency. But only 1500 patients are treated for hepatitis B each year.
"If universal and selective vaccination was implemented in the United Kingdom, as it has been in 150 other countries, this figure would be significantly reduced and the nation would be better protected," said Roger Williams, director of the foundation. The report was launched in the House of Commons this week.
"We are one of the few countries not to offer universal vaccination," said Professor Williams, "The government used to say it was not cost effective and we didn抰 have a problem, but the situation is changing."
The change has in part been due to the influx of people to the United Kingdom from countries where hepatitis B is more prevalent. And universities have been accepting more overseas students from countries such as China, where the incidence in the population is 3-4%, said Professor Williams.
Travellers abroad from the United Kingdom who had not been vaccinated but had sexual contacts while away also ran the risk of contracting the disease and bringing it back to the United Kingdom, he added.
To vaccinate all 700 000 children in the United Kingdom at birth would cost about ?1m ($38m; �30m) a year, since a course of three vaccinations costs about ?0. The initial costs of a programme to vaccinate all children less than 5 years old, however, would be about ?05m. The cost of treatment is about ?500 for someone in the late stage of the disease.
Without treatment (which includes interferon a , lamivudine, and adefovir dipivoxil) hepatitis B can eventually lead to liver cirrhosis and cancer. Professor Williams admitted that he had some involvement with the company that produces adefovir dipivoxil, although not with the companies producing the other drugs nor the manufacturer of the vaccine.
Steven Wiersma, medical officer with the World Health Organization, said the foundation抯 initiative was exciting news, "Countries with low prevalence thought they could tackle it best by other strategies, such as safe sex messages. But it抯 been shown those strategies are very hard to implement."
The United States switched from selective vaccination to universal vaccination of all infants in 1991. Holland is another exception, like the United Kingdom, which has not adopted universal vaccination.
A spokesperson for the Department of Health said that a working group of the Joint Committee on Vaccination and Immunisation was currently considering whether the current immunisation programme for hepatitis B might need to be strengthened or expanded in future. "No conclusions have been reached yet," she said, "But they should finalise their position next year."(London Lynn Eaton)