Anthony Burton
Background: The universal administration of a birth dose of the hepatitis B vaccine within the first 24 hours of life is crucial for preventing perinatal hepatitis B virus transmission and can significantly reduce the disease burden of chronic hepatitis B infection. Unlike with the majority of vaccines recommended by WHO, there is currently no methodology to generate hepatitis B birth dose coverage estimates. Methods: Methods used by the WHO and UNICEF for estimating coverage for other vaccines were expanded to include indicators that allow validation of timeliness of administered hepatitis B birth doses in Western Pacific Countries. These indicators include percentages of births with skilled attendance or in health facilities and differences between WHO/UNICEF estimates and country-reported coverage for other vaccines. Results: We made hepatitis B birth dose estimates for 23 countries between 1999 and 2010. Estimates for the 2010 birth cohort ranged from 99% (eight countries) to as low as 2% (Viet Nam. Estimates for ten of 23 countries different from data reported by national authorities for at least one year. In some countries, the variability was as great as 50%. In several instances, estimates incorporating indicator data were different from those generated by the standard WHO/UNICEF protocol. Conclusions: A protocol for estimating hepatitis B birth dose coverage has been proposed and we have shown that supplemental indicator data can provide useful validation. Extrapolation to other regions will require availability of similar data.