Hepatitis B Prevention in Vietnam

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1 Hepatitis B Prevention in Vietna Presented by Assoc.Prof. Duong Thi Hong, PhD NHE Vice Director, EPI Deputy anager

2 Hepatitis B Prevalence/incidence in country Hep B HBsAg positives (%) General population 10-20% (Nguyen Thu Van, 2002) Blood donors 14.7% (Nguyen Thi Nga, 1995) Pregnant woen 12.6% (Phi Duc Long, 2010) Healthcare workers 9% (TTHue Health Service Dept.) Liver cancer 77.2% (Nguyen Thi Nga, 1995) Neonates whose others HBsAg (+) & HBeAg (+) Hep B pos pregnant woen 21.7% 62.5% (Phi DucLong, 2010) % HBeAg % (Phi DucLong, 2010) Serosurvey in 51 provinces - WHO HBsAg + (%) Social Rural 2.34 econoic Urban Birth corhorts Gender Male 2.2 Feale 2.33 Hospital 1.82 Place of birth Coune Health Center 2.1 At hoe 4.76 Others 2.36

3 Vaccination schedules 2018 Available free fro the gov Recoended not for free Iunization Schedule winthin EPI Disease Vaccine brand nae Birth 2 Hepatitis B birthdose Hepatitis B <24hrs BCG BCG X bopv bopv X X X IPV Iovax X Diphtheria/Tetanus/ pertussis/hepatitis B/Hib 3 Quinvaxe X X X DPT booster DPT X Measles or MR MVVAC MRVAC JE Innactive JE X X X X 24

4 Vaccination coverage Iunization coverage (%) Vaccine 1990 Year Year BCG DTP3 86.5% HepB3 1.2 (1997) HepB_BD NA , Hib3 NA 93.4% (2010) 94.4 IPV1 NA (introduced fro Jul 2018) OPV JE3 2 (1997) MCV MCV2 NA

5 Universal of hepatitis B in your country Hepatitis B Yes/no Target who is vaccinate + age if relevant Since/period Universal Yes Infant, including birth dose 1997 (birth dose since 2002) Risk groups No

6 Hepatitis B prevention- Iunization cobined/ono valent Available hepatitis vaccines Disease NAME producer Target group Issues Monovalent with hepatitis/ Cobined HepB what are the HepB vaccine, VABIOTEC probles in your country with use of cobined Hep B (local anufacture) neonates Opportunities how do you think this issues can be solved Cobined DPT-HepB-Hib Quinvaxe, Berna Biotech 2, 3, 4 onths

7 HepB3 Coverage (%) HepB3 coverage, AEFIs Stock out Pentavalent vaccine withdrawn (May-Sep) , ,2 97,1 96,1 69,7 88,7 94,5 87,5 95,2 96,6 59,4 95,2 96, , ,2 12,2 19,1 21,1 18,5

8 HepB birth dose within 24h after birth(%) HepB Birth Dose Coverage, ,0 90,0 80,0 70,0 60,0 54,6 59,5 62,2 64,3 AEFIs Stock out AEFIs 55,0 75,6 56,0 55,0 76,6 69,8 68,0 50,0 40,3 40,0 30,0 28,6 25,5 21,4 20,0 10,0 0,0 <3 days <24 hrs By Years

9 Hepatitis B prevention- Iunization cobined/ono valent Issues with hepatitis/ Cobined what are the probles in your country with use of cobined Hep B Severe adverse events in 2013: vaccine suspended in 5 onths Vaccine hesistancy in urban areas: delayed, unvacctinated increasing trend of pertussis recently Low vaccine coverage in hard-to-reach areas diphtheria Vaccine stock out at soe points Opportunities how do you think this issues can be solved Strenthen capacity of the syste: training, supportive supervision, issue legal docuents. Iproveent of AEFIs surveillance, investigation and tiely responses. Counication through social networks, websites, television, newspapers,, risk counication. Support to increase vaccine delivery in hard-to-reach areas Vaccine supply

10 Vietna Extra inforation on HepB birth dose Yes/no Since/period Coverage Birth dose in universal progra Yes % (in 2017) Issues with HepB BD in your country Successes with HepB BD in your country Negative ipact of severe adverse events in 2007 & 2013 Low and unstable vaccine coverage Vaccine hesistancy aong HCWs, especially hospitals over contraindication of High rate of hoe birth delivery in ountainous areas neonates iss chance of vaccine access Counication: tiely & active counication. Iproveent of AEFIs surveillance, investigation and tiely responses. Training for HCWs at hospital in provinces with low vaccine coverage Revise guideline on health screening for vaccine indication Moutainous areas: o Expanding odel of CHC-based and polyclinicbased vaccine delivery o Deonstration of house to house vaccine delivery o Encourage PW to delivery birth at health facility

11 THANK YOU FOR YOUR ATTENTION!