Abstract

To combat vertical transmission of hepatitis B virus infection in a low prevalence area, passive and active immunization against hepatitis B was incorporated into the national Dutch immunization program in October 1989. Neonates of mothers found HBsAG-positive by screening receive hepatitis B immunoglobulin at birth and active immunization with hepatitis B vaccine at 3,4, 5 and 11 months of age. Vaccination data were requested for quarterly birth cohorts. The cohorts described are those born between October 1989 and December 1990. Data on 490 neonates at risk for hepatitis B have been analysed to examine the administration of passive active immunization during the first year of life. The average coverage was 83% for immunoglobulin, 90% for the lst HB vaccination, 86% for the 2nd, 80% for the 3rd and 55% for 4th HB vaccination. In 19% of neonates (n=93) there was a delay in immunoglobulin administration beyond 48 hours or it was not known whether it was administered or not. There was considerable variation in vaccine administration. Although compliance with the vaccination generally appeared satisfactory for this program in the first 15 months, 20-40% of infants were not properly immunized. Frequently doses were received later than planned. From these data it appeared feasible to establish hepatitis B immunization services at Health Bureaus dealing with DTP-polio. Continuous attention is needed for public education to improve adherence to the immunization schedule.