Hepatitis B transmission is preventable through hepatitis B vaccination. Effective implementation of Australia’s vaccination program will largely eradicate transmission and the subsequent impact of infection.
The hepatitis B vaccine is available through the Immunise Australia Program for infants at birth and at 2, 4, 6 and 12 months, as well as for children aged 10 to 13 years. Identifying mothers with chronic hepatitis B during pregnancy is essential for reducing transmission to the newborn and providing care to the mother.14 This will also provide an opportunity to vaccinate others in households.
Levels of knowledge about hepatitis B are poor among people who inject drugs. This group is often unaware of hepatitis B vaccination15 and often does not complete vaccination regimens.16 There is evidence of efficacy with an accelerated vaccination schedule which may make vaccination more accessible.17 Needle and syringe programs may also play a role in assessing hepatitis B virus status and providing vaccination where indicated.
There is a lack of consistency between jurisdictions in the level of public information through departmental websites about accessing funded hepatitis B vaccination, resulting in at-risk communities not being aware of the availability of funded vaccination. Effective promotion through peer education to both people who inject drugs and sex workers would assist in increasing awareness about the availability of the vaccine for hepatitis B.
As well as promoting the vaccination broadly, opportunistic hepatitis B testing and vaccination in young people should be considered, particularly for young people with multiple risk factors or who may have missed childhood vaccination. This could be incorporated into Adult Health Checks for Aboriginal and Torres Strait Islander peoples; on engagement with the juvenile justice system; and in association with recruitment activities such as is the case with the Australian Defence Force.
Improving the capacity of countries in Australia’s region—particularly those with a greater hepatitis B burden—to develop and successfully implement immunisation campaigns will have a long-term systemic impact on reducing the burden of hepatitis B on the Australian community.
Priority actions in prevention
- Promote national consistency in groups and communities eligible for funded vaccination, giving priority to communities at greatest risk of hepatitis B infection.
- Increase the uptake of hepatitis B vaccination among priority populations, thereby reducing the social impact, morbidity and mortality associated with undetected or untreated infection.
- Increase awareness of hepatitis B prevention through integrated health promotion interventions promoting safe sex and safe injecting.
- Identify an appropriate follow-up schedule for children born to at-risk mothers and promote appropriate monitoring.
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14 Wiseman E, Fraser MA, Holden S, Glass A, Kidson BL, Heron LG & Maley MW, Ayres A Locarnini SA & Levy M ‘Perinatal transmission of hepatitis B virus: an Australian experience’, Medical Journal of Australia 2009, ed.190, vol. 9, pp. 489–492.
15 Day C, White B, Ross J & Dolan K ‘Poor knowledge and low coverage of hepatitis B vaccination among injecting drug users in Sydney’, Australian and New Zealand Journal of Public Health, 2003, vol 27: p. 558.
16 Maher, L et al 2003.
17 Rogers N & Lubman DI ‘An accelerated hepatitis B vaccination schedule for young drug users’, Australian and New Zealand Journal of Public Health 2005, vol. 29, pp. 305–7.