Nationwide Hepatitis B Vaccination Program in Taiwan: Effectiveness in the 20 Years After It Was Launched

The national hepatitis B vaccination program in Taiwan is considered one of the most successful and effective public health programs to control chronic hepatitis B infection in the past 20 years. This review illustrates how to implement a successful hepatitis B vaccination program based on Taiwan’s experience. Several important controlled randomized clinical trials on hepatitis B immunoglobulin and vaccine in Taiwan demonstrated an 80– 90 % protective effect among infants of mothers who were positive for either hepatitis B envelope antigen or hepatitis B surface antigen. A series of prevalence surveys on children born before and after the national vaccination program began disclosed a steady decrease in seroprevalence of hepatitis B surface antigen in Taiwan, with 78–87 % effectiveness after the national vaccination program was launched. Studies on the secular trend of liver disease risk also documented a 68 % decline in mortality from fulminant hepatitis in infants and a 75% decrease in the incidence of hepatocellular carcinoma in children 6–9 years of age after the national vaccination program began. In conclusion, since 1984, the national hepatitis B vaccination program has been successful in preventing acute and chronic liver diseases in Taiwan. hepatitis B vaccines; liver diseases; program evaluation; public health; regional health planning; Taiwan; treatment outcome; vaccination Abbreviations: HBeAg, hepatitis B envelope antigen; HBIG, hepatitis B immunoglobulin; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus