The Hepatitis B vaccine is extremely safe – over 70 million have been given in the U.S. since 1982 and over 1 billion doses have been administered worldwide! The first vaccine against a major human cancer, it is given as 3 doses over a period of 6 months for maximum protection. The first dose of vaccine is ideally given within the first 24 hours of birth because an infant is most susceptible to Hepatitis B infections in the first year of life. Children between 11-15 years of age can receive a two-dose vaccine sequence.

Scientists have spent so much time and resources yet cannot save the 10 million lives destroyed every year by AIDS or cancer. How can we explain why we are not helping the 1.25 million people who die from Hepatitis B annually, even though we have had a safe and effective vaccine for 26 years? This is a true human tragedy.

Of all places on Earth, China has the greatest burden of hepatitis B. Out of the 350 million chronically infected worldwide, over one third are living in China. These 120 million people account for 9% of China’s population. It is not unjustifiable to say that Hepatitis B is the national disease of China. Estimates of annual deaths caused by Hepatitis B range from 300,000 to 500,000 Chinese.

Luckily, the China-Global Alliance for Vaccines and Immunization partnership is fighting the virus on its own turf. Between 2003 and 2006, 15 million children under the age of 5 in China-GAVI targeted provinces received Hepatitis B vaccines. The Chinese government has also had a free, universal Hepatitis B vaccination program since 2002 for infants. However, 3 major areas – Tibet, Guizhou, and Yunnan – and nearly 50% of all China-GAVI targeted counties still have timely birth dose coverage levels under 75%. There is still plenty of work to be done as far as young children and infants are concerned.

County-level poverty incidence map of Yunnan

Achieving the goal of the ultimate elimination of Hepatitis B in China would take generations unless the nation implements a catch-up vaccination program for young children and adolescents. Consider this: in 1997, 30% of infants received an HBV birth dose, and only 70% completed the HepB 3-dose series. There was no national Hepatitis B survey conducted before 1997, but it is safe to assume vaccination coverage was even lower before then. That means there are tens of millions of young children and adolescents who are HBV carriers. Later in life, many will develop liver cancer and die. The infant immunization program will not protect them.

WCO’s Action Plan

Of the provinces with low Hepatitis B vaccination coverage rates, WCO has chosen Yunnan Province in western China as a starting point. We can deal a severe blow to Hepatitis B in Yunnan by instituting a mass vaccination catch-up program for school-aged children. We will target younger children of elementary and middle school age - between 6 and 15 – to maximize the preventive potential of our hepatitis B vaccines. We chose the western province of Yunnan and are organizing a 3-dose, 6 month hepatitis B vaccination project.

There are 4 main items necessary in our vaccination campaign:

1. Hepatitis B educational materials to inform the public
2. The Hepatitis B vaccine, which is manufactured locally in China as single-dose ampoules
3. Auto-disable (AD) syringes – these syringes feature locking or deforming mechanisms to ensure single injection usage. AD syringes are standard equipment for mass immunization campaigns.
4. Safety boxes – these puncture-proof containers are for the safe and convenient disposal of used syringes and needles. They are filled once and then disposed of through incineration.

We estimate that the cost is 5-6 U.S. dollars for each person, so the total cost for the vaccination of 100,000 schoolchildren would be 500,000 dollars.

As schoolchildren age, the possibility that they have already been affected by HBV also increases. We must vaccinate them as soon as possible or they may be infected by HBV. Every week is a week they could be infected by hepatitis B. Let us take action now.