For the last 30 years, the Hepatitis B vaccine has been successfully introduced in a number of countries across the globe where it has helped reduce the incidence of these infections. There are an estimated 40 million chronic Hepatitis B virus (HBV) carriers in India which constitute about 11% of the global burden of this infection. Since 2007-08, the Hepatitis B vaccination program has becomes an integral part of the Universal Immunization Program across 10 states in India. The Indian national policy recommends that children receive this vaccine along with the DPT and the trivalent polio vaccine at 6, 10 and 14 weeks in addition to a birth dose.
However, the low coverage of the HBV vaccine, compared to the similarly timed DPT, prompted the World Health Organization - India's National Polio Surveillance Project (NPSP) to assess the possible reasons behind this scenario. The assessment was carried out between August and December 2009 in selected districts in Punjab, Madhya Pradesh, West Bengal, Karnataka and Tamil Nadu.
The study assessed that some of the reasons for the poor coverage included poor stock management, incomplete recording and reporting, the perceived high cost of the vaccine, the fear of wastage of vaccine because of the 10-dose vial, and incomplete knowledge amongst health professionals about the vaccine schedule. Clear, precise instructions along with improved management of vaccine stocks could help improve the coverage for this – and other new vaccines.
Source: Lahariya C et al. An assessment of hepatitis B vaccine introduction in India: Lessons for roll out and scale up of new vaccines in immunization programs. Indian J Public Health 2013;57:8-14