Vaccination against Hepatitis B: 20 years later

More than 20 years have elapsed since 1984, when vaccination against Hepatitis B began, first with a plasma-derived vaccine and later a recombinant DNA-derived vaccine, and during this period important changes have taken place in several aspects of this disease: the acute and chronic infection rates, the mortality of fulminant Hepatitis B in infants and the incidence of hepatocellular carcinoma have been effectively reduced by approximately 25%. Vaccination during childhood has produced adequate protection for up to 20 years later. The appearance of Hepatitis B surface gene mutants in DNA HBV positive children has been confirmed, gradually increasing from 7.8% before vaccination to 23.1% 15 years later. To date, there is no evidence that those viruses are disrupting the efforts to control Hepatitis B through immunization programmes. A good immune response through the vaccination of premature infants with low birth weight has been implemented by delaying the start of the vaccination programme to between 7 and 30 days after birth. It has also been proposed that there is an increased risk of non-response to the Hepatitis B vaccine among elderly people. Finally, it has been proven that the Hepatitis B vaccine is one of the safest Vaccines available in the world.