Hepatitis B immunisation

Published

22 Nov, 2017

Chronic hepatitis B or C infection is the most common risk factor for liver cancer.¹ Together these diseases are estimated to cause up to 80% of liver cancer cases globally.² In Australia, the prevalence of chronic hepatitis B is approximately 1% of the population,³ with a higher prevalence occurring in people born in certain countries (such as Vietnam, Cambodia, China, Taiwan and Afghanistan) and Aboriginal and Torres Strait Islander peoples.^3,8 Studies have shown that the risk of developing liver cancer can be up to 20 times higher in people with chronic hepatitis infection than among the general population.^4,5

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Notes

• Data sourced from Australian Government Department of Health - Communicable Diseases Intelligence reports.
• Break in series from 2009 onwards, refer to ‘About the data’ for more information.
• Data by Indigenous status not available for 2010.

Hepatitis B immunisation coverage rates for Australian children aged 24 to 27 months, 2003 to 2015
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Notes

• Data sourced from OECD
• Percentage of children under one year old who have received three doses of hepatitis B vaccine in a given year.
• Note: The age of complete immunisation differs across countries due to different immunisation schedules. In addition Immunisation against Hepatitis B is mandatory in certain countries while it is only optional in others (e.g. Canada and France among others).

Hepatitis B immunisation coverage rates for infants, selected countries, 2017

About this measure

It has been projected that in 2016, there will be 1,840 new diagnoses and 1,805 deaths due to liver cancer in Australia. In addition, the age-standardised mortality rate for liver cancer has been increasing over time, from 2 deaths per 100,000 persons in 1980 to 6 per 100,000 in 2013 (see NCCI Indicator – Mortality).

There are effective vaccines available in Australia for hepatitis B which, since 2000, have been free-of-charge for vaccination of infants. Vaccinations are provided under the National Immunisation Program Schedule;⁶ doses are administered to infants soon after birth, followed by doses at two, four and six months of age. ‘Immunisation coverage’ is defined as including children notified to the Australian Immunisation Register (AIR) as receiving three doses of any hepatitis B vaccine at a designated age, in this case, at 24-27 months.⁷

Current status

Hepatitis B immunisation coverage is very high (95% in 2015) among Australian children aged 24-27 months.

Aboriginal and Torres Strait Islander children

Hepatitis B immunisation coverage rates are similar or higher in most years among Indigenous children when compared with non-Indigenous children: in 2014, the coverage rate for Indigenous children was 95.2% compared with 94.6% for non-Indigenous children. Immunisation coverage rates at 12 months of age are lower among Aboriginal and Torres Strait Islander children, which may predispose to subsequent hepatitis B-related diseases.⁸

International comparisons

Hepatitis B immunisation coverage in Australia is similar to that seen in most other comparable countries, with almost all economically developed countries having infant coverage rates above 90% for Hepatitis B.

With the exception of Indigenous peoples, national hepatitis B immunisation data for other population groups (e.g. groups classified by sex, remoteness or socioeconomic status) are not readily available.

Trends

Since 2003, hepatitis B immunisation coverage has remained consistently high at around 95%. This may be due to the introduction of the universal infant immunisation program in 2000.⁹ The stable trend over time for immunisation coverage also applies to Aboriginal and Torres Strait Islander children.

About the data

This measure shows the proportion of Australian children aged 24 to 27 months who have been notified in the Australian Immunisation Register (AIR) as receiving three doses of any hepatitis B vaccine. A three-month lag period (i.e., 24 to 27 months) is allowed for late notifications to the AIR. The cohort method has been used for calculating immunisation coverage at the population level (refer to Reference 7 for more information).

Numerator: Children aged 24 to 27 months who have been notified in the Australian Immunisation Register (AIR) as receiving three doses of any hepatitis B vaccine.

Denominator: Total number of Medicare-registered children aged 24 months.

Data sources

Australian data are sourced from the AIR. Participation in the AIR is based on an “opt-out process” which has achieved close to complete population coverage.⁷

Analyses of AIR data are presented in Communicable Diseases Intelligence reports.¹⁰ Data are also published in annual immunisation coverage reports by the National Centre for Immunisation Research & Surveillance.¹¹

International data are sourced from the Organization for Economic Co-operation and Development (OECD.Stat. Health Statistics database, accessed August 2018) that utilise the WHO/UNICEF published estimates of national immunization coverage. Most of the data are derived from official reports by WHO Member States reported annually through the WHO/UNICEF joint reporting process.

Data caveats

- Australian trend data from 2009 are not strictly comparable to earlier data due to a change in the algorithm used to derive hepatitis B immunisation coverage.

- International immunisation coverage data sourced from OECD.Stat on % of children immunised for 2017. Percentage of children under one year old who have received three doses of hepatitis B vaccine in a given year.
Note: The age of complete immunisation differs across countries due to different immunisation schedules. In addition Immunisation against Hepatitis B is mandatory in certain countries while it is only optional in others (e.g. Canada and France among others).

References

Activity in this area:

Data:

Australian Government Department of Health. About Communicable Diseases Intelligence. http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-pubs-cdi-cdiintro.htm

The Kirby Institute for infection and immunity in society: Surveillance: http://kirby.unsw.edu.au/surveillance

Immunisation coverage rates are published by the AIR at Statistical Area 3-level: https://beta.health.gov.au/topics/immunisation/childhood-immunisation-coverage/immunisation-coverage-rates-for-all-children

Policy:

Immunise Australia Program. https://beta.health.gov.au/health-topics/immunisation

References:

1. American Cancer Society 2014. Liver Cancer. Available from: https://www.cancer.org/cancer/liver-cancer/causes-risks-prevention/risk-factors.html (accessed 9 August 2017).

2. Cancer Council Victoria. Hepatitis & liver cancer. Available from: www.cancervic.org.au/for-health-professionals/community-health-professionals/hepatitis-b-and-liver-cancer (accessed 5 January 2016).

3. Antonsson A et. al. 2015. Cancers in Australia in 2010 attributable to infectious agents. Aust NZ J Public Health. 2015; 39:446-51.

4. Amin J et al. 2006. Cancer incidence in people with hepatitis B or C infection: a large community-based linkage study. J Hepatol45(2):197-203.

5. Cancer Council Australia. National Cancer Control Policy – Liver Cancer. Available at: http://wiki.cancer.org.au/policy/Liver_cancer (accessed October 2016).

6. Immunise Australia Program 2015. National Immunisation Program Schedule. Available from: https://beta.health.gov.au/topics/immunisation/immunisation-throughout-life/national-immunisation-program-schedule (accessed 5 January 2016).

7. National Centre for Immunisation Research & Surveillance 2013. Annual Immunisation Coverage Report 2013.

8. The Kirby Institute. 2015. HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2015. The Kirby Institute, UNSW: Sydney, Australia

9. Australian Technical Advisory Group on Immunisation (ATAGI). 2016. The Australian immunisation handbook 10th ed (2016 update). Canberra: Australian Government Department of Health.

10. Australian Government Department of Health. About Communicable Diseases Intelligence. http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-pubs-cdi-cdiintro.htm (accessed October 2016).

11. NCIRS. Immunisation coverage. http://www.ncirs.edu.au/surveillance/immunisation-coverage/ (accessed October 2016).

12. OECD.Stat. Accessed August 2018; http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT#

Summary

Hepatitis B Immunisation coverage is very high in Australian childrenIn 2015, Hepatitis B immunisation coverage was 95% among Australian children aged 24-27 months.

Hepatitis B Immunisation coverage rates are similar for Indigenous and non-Indigenous Australian childrenIn 2014 Hepatitis B immunisation coverage was 95.2% in Indigenous Australian children and 94.6% in non-Indigenous Australian children. 

Hepatitis B immunisation coverage rates are similar to other developed countriesHepatitis B immunisation coverage rates for Australian infants was 95%, and is similar to that seen in most other comparable countries, with almost all economically developed countries having infant coverage rates above 90% for Hepatitis B.

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Data

Summary

Hepatitis B Immunisation coverage is very high in Australian children

Hepatitis B Immunisation coverage rates are similar for Indigenous and non-Indigenous Australian children

Hepatitis B immunisation coverage rates are similar to other developed countries