Published 26 Jun, 2024

Chronic hepatitis B and C infections are the most common risk factors for liver cancer globally, accounting for an estimated 80% of all liver cancers.1 Primary liver cancer is the sixth most commonly diagnosed cancer and was rated the third leading cause of cancer death worldwide in 2020.2Studies indicate that the risk of developing liver cancer can be 20-30 times higher in people with chronic hepatitis infection than among the general population.3

In 2023 in Australia, the estimated number of new cases of liver cancer diagnosed was 3,048, with an age-standardised mortality rate of 9.7 deaths per 100,000 persons.4 (age standardised to the 2023 Australian Standard Population)

Charts

Hepatitis B and hepatitis C infections are main risk factors for Hepatocellular carcinoma development.5,6

Hepatitis B is a common blood borne virus (BBV) in Australia and a leading cause of primary liver cancer.7-8 Hepatitis B among adolescents and adults in Australia is transmitted through a variety of pathways, including injecting drug use and sexual contact. Seventy-two per cent of people living with chronic hepatitis B in Australia are either from cultural and linguistically diverse (CALD) backgrounds or are Aboriginal and Torres Strait Islander people who likely acquired hepatitis B at birth or in early childhood.8

Vaccination is the corner‑stone of hepatitis B primary prevention. Hepatitis B immunisation programs have been rolled out in different states and territories with different timelines since 1985. In the Northern Territory, hepatitis B screening was introduced for all pregnant women and vaccination to infants born to mothers living with chronic infection in 1985; universal infant vaccination was implemented in 1990, and a catch‑up program for children aged 6 to 16 years was introduced in 1998. In other states and territories, hepatitis B vaccination of all infants commenced in 2000, and a universal adolescent (ages 11 to 14 years) school‑based hepatitis B vaccination catch‑up program commenced in 1998 in Victoria and Tasmania, in 1999 in South Australia and the Australian Capital Territory, in 2002 in Western Australia, in 2004 in New South Wales, and in 2007 in Queensland.9

Vaccinations are provided under the National Immunisation Program Schedule with doses administered to infants soon after birth, followed by doses at two, four and six months of age.10-11 

The Australian Immunisation Register (AIR) is a national register that records vaccines given to all people in Australia at its expansion in 2016, including all vaccines under the National Immunisation Program, COVID-19 vaccines, and vaccines given privately as for seasonal influenza. Since July 2021, it was mandated to report to AIR all COVID-19 vaccinations administrated on or after 20 February 2021, Influenza vaccinations administered on or after 1 March 2021, NIP vaccinations administered on or after 1 July 2021, and Japanese encephalitis virus (JEV) vaccinations administered on or after 21 December 2022.12

Childhood cohort vaccination status was assessed for fully vaccinated (as defined by the Australian Government Department of Health and Aged Care, including certain specific vaccine doses that should have been received by the relevant age milestone) and for individual vaccines at the standard milestones – 12 months of age (for vaccines due at 6 months), 24 months of age (for vaccines due at 6, 12 and 18 months) and 60 months of age (for vaccines due at 48 months).13

In 2022, coverage of hepatitis B vaccination at 12 months of age was 93.8%, and 95.9% by 24 months of age, respectively.13,14

The coverage rate at 12 months of age was higher in non-Indigenous children than in Aboriginal and Torres Strait Islander children (94% vs 90%). The coverage rate at 24 months of age was the same irrespective of Indigenous status at 96%.13,14

This measure shows the proportion of Australian children aged 12 to 15 months and 24 to 27 months respectively who have been notified to the Australian Immunisation Register (AIR) as receiving three doses of hepatitis B vaccine. A three-month lag period (i.e., 24 to 27 months) is used to provide for late notifications to the AIR. The cohort method has been used for calculating immunisation coverage at the population level.13

Hepatitis B vaccine coverage is defined operationally to include children notified to the Australian Immunisation Register (AIR) as receiving three doses of any hepatitis B vaccine due at 6 months when reaching age assessment milestones of 12, 24 and 60 months.13

Numerator: Children aged 12 to 15 months and 24 to 27 months who have been notified to the Australian Immunisation Register (AIR) as receiving three doses of a hepatitis B vaccine due at 6 months.

Denominator: Total number of Medicare-registered children in the relevant age cohort.

Coverage estimates were calculated using 12-month-wide cohorts and Australian Immunisation Register data were concluded as at 3 April 2022 (for 2021 coverage) and 2 April 2023 (for 2022 coverage).13

 

Data sources:

Australian data are sourced from the Australian Immunisation Register (AIR). The Australian Immunisation Register (AIR) is a national register that records vaccines given to all people in Australia at its expansion in 2016, including all vaccines under the National Immunisation Program, COVID-19 vaccines, and vaccines given privately as for seasonal influenza.

All people registered with Medicare are automatically added to the AIR and assigned a unique Personal Identification Number (PIN) that then travels with that person for life, across all relevant Medicare card numbers (e.g. where there are multiple cards due to family circumstances or maturity). Participation in the AIR is ‘opt-out’, with AIR constituting a nearly complete population register for Australian residents.13

Data:

The Kirby Institute. Hepatitis B. Accessed May 2024; https://data.kirby.unsw.edu.au/hepatitis-b

 

National Centre for Immunisation Research and Surveillance Australia. Annual Immunisation Coverage Report 2022. Accessed May 2024; https://ncirs.org.au/sites/default/files/2024-01/NCIRS%20Annual%20immunisation%20coverage%20report%202022.pdf

 

Policy:

Department of Health: Immunisation. https://www.health.gov.au/health-topics/immunisation

Australian Government Department of Health. National Immunisation Program schedule for all Aboriginal and Torres Strait Islander people. Available from: https://www.health.gov.au/resources/publications/national-immunisation-program-schedule-for-all-aboriginal-and-torres-strait-islander-people

Australian Government. Department of Health and Aged Care. Fourth National Hepatitis B Strategy 2023-2030. Accessed May 2024;

https://www.health.gov.au/sites/default/files/2023-05/fourth-national-hepatitis-b-strategy-2023-2030.pdf

Australian Government. Department of Health and Aged Care. Third National Hepatitis B Strategy 2018-2022. Accessed May 2024; https://www.health.gov.au/sites/default/files/documents/2022/06/third-national-hepatitis-b-strategy-2018-2022.pdf

National Centre for Immunisation Research and Surveillance. Significant events in hepatitis B vaccination practice in Australia. Sydney: NCIRS; 2015 https://www.ncirs.org.au/sites/default/files/2021-07/Hepatitis-B-history-July%202021.pdf

Australian Government. Department of Health and Aged Care. National Immunisation Program schedule. Accessed May 2024; https://www.health.gov.au/resources/publications/national-immunisation-program-schedule?language=en

 

References

  1. El-Serag HB. Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology. 2012 May;142(6):1264-1273.e1. 
  2. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. 
  3. Amin J, Dore GJ, O'Connell DL, et al. Cancer incidence in people with hepatitis B or C infection: a large community-based linkage study. J Hepatol. 2006 Aug;45(2):197-203. 
  4. Australia Government. Cancer Australia. Liver cancer in Australia statistics. Accessed May 2024; https://www.canceraustralia.gov.au/cancer-types/liver-cancer/statistics. 
  5. Llovet, J.M., Kelley, R.K., Villanueva, A. et al. Hepatocellular carcinoma. Nat Rev Dis Primers 7, 6 (2021).
  6. Zhang X, Guan L, Tian H, et al. Risk Factors and Prevention of Viral Hepatitis-Related Hepatocellular Carcinoma. Front Oncol. 2021 Sep 9; 11:686962.
  7. MacLachlan JH, Romero N, Purcell I, Cowie BC. Viral Hepatitis Mapping Project: Hepatitis B. National Report 2021. Darlinghurst, NSW: Australasian Society for HIV, Viral Hepatitis, and Sexual Health Medicine (ASHM), 2023.Accessed May 2024; https://ashm.org.au/wp-content/uploads/2023/09/Viral-Hepatitis-Mapping-Project_National-Report-Hepatitis-B-2021.pdf
  8. Australian Government. Department of Health and Aged Care. Third National Hepatitis B Strategy 2018-2022. Accessed May 2024; https://www.health.gov.au/sites/default/files/documents/2022/06/third-national-hepatitis-b-strategy-2018-2022.pdf
  9. National Centre for Immunisation Research and Surveillance. Significant events in hepatitis B vaccination practice in Australia. Sydney: NCIRS; 2015 https://www.ncirs.org.au/sites/default/files/2021-07/Hepatitis-B-history-July%202021.pdf
  10. Australian Government. Department of Health and Aged Care. National Immunisation Program schedule. Accessed May 2024; https://www.health.gov.au/resources/publications/national-immunisation-program-schedule?language=en
  11. Australian Government. Department of Health and Aged Care. Australian Immunisation Handbook. Accessed May 2024; https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/hepatitis-b
  12. Australian Government. Department of Health and Aged Care. Using the Australian Immunisation Register; Accessed May 2024; https://www.health.gov.au/topics/immunisation/immunisation-information-for-health-professionals/using-the-australian-immunisation-register
  13. National Centre for Immunisation Research and Surveillance Australia. Annual Immunisation Coverage Report 2022. Accessed May 2024;

https://ncirs.org.au/sites/default/files/2024-01/NCIRS%20Annual%20immunisation%20coverage%20report%202022.pdf

  1. The Kirby Institute 2023. HIV, viral hepatitis and sexually transmissible infections in Australia Annual surveillance report 2023 - Hepatitis B. The Kirby Institute, UNSW: Sydney, Australia. Accessed May 2024; https://www.kirby.unsw.edu.au/sites/default/files/documents/Annual-Surveillance-Report-2023_HBV.pdf

Summary

The coverage rate at 24 months of age was the same irrespective of Indigenous status at 96%.

Hepatitis B vaccination coverage rates have increased in Indigenous children aged 12-15 months

Between 2013 and 2018, immunisation rates for Indigenous infants aged 12-15 months increased from around 87.3% to 95.6%.

Hepatitis B immunisation coverage rates remained high in Australia.

Hepatitis B vaccination coverage rates for children remained high in Australia at above 90% for ages 12 months (93.8%), and above 95% (95.9%) for children aged 24 months.

Related indicator
Hepatitis B and Hepatitis C notification

In this Measure

Topics

Hepatitis
Immunisation
Infectious disease

Other measures in this indicator

Hepatitis B and Hepatitis C notification

Related measures

Hepatitis B and C notifications