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Research Letter
September 4, 2013

Thirty-Year Outcomes of the National Hepatitis B Immunization Program in Taiwan

Author Affiliations
  • 1Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
  • 2Taiwan Cancer Registry, Taipei, Taiwan
  • 3Genomics Research Center, Academia Sinica, Taipei, Taiwan
JAMA. 2013;310(9):974-976. doi:10.1001/jama.2013.276701

Hepatitis B virus (HBV) infection causes infant fulminant hepatitis (IFH), and chronic HBV infection may progress to chronic liver disease (CLD) and hepatocellular carcinoma (HCC). Taiwan launched a nationwide HBV immunization program for newborns in July 1984,1 which has successfully lowered the prevalence of chronic HBV carriers, incidence of HCC, and mortality of IFH in vaccinated birth cohorts.2-4 The mortality of CLD before and after HBV immunization has never been examined. We assessed the 30-year outcomes of the immunization program.

From July 1984 to June 1986, the immunization program covered only newborns with high-risk mothers who were seropositive for HBV surface antigen. Coverage was extended to all newborns in July 1986, preschool children in July 1987, and primary school children in 1988-1990. Recombinant HBV vaccines replaced plasma-derived vaccines in 1992. The immunization coverage rates for birth cohorts from 1984 to 2010 was 88.8% to 96.9%.2,5