Editorial on “What is a potentially damaging vaccination delay in children younger than 2 years?”

ABSTRACT

Control of hepatitis B through routine infant immunization in more than 95% of countries has reduced the prevalence of chronic hepatitis carriers to less than 1%–2% in immunized cohorts of children even in high endemicity countries. In that context the authors of this editorial found the results of a paper by Gras et al in this issue concerning. They performed a Delphi survey of 37 French immunization experts and the results concluded that delayed hepatitis B immunization would cause “potential damage” only after 11 years. Large cohorts of French children and adolescents remain susceptible to hepatitis B infection. Given the high rates of immigration to France from areas of higher endemicity, the higher birth rate and degree of integration of these groups into the health system, plus the lower age of sexual debut and the use of injectable drugs in the general population, we cannot agree that a delay of 11 years is acceptable. Rates of adolescent immunization are quite low so relying on protection at this age will yield little in terms of population protection. Loss of confidence in Hepatitis B vaccine following disproved allegations that the vaccine caused Multiple Sclerosis persists in France, and we believe the results of this paper sends a damaging message to health workers and parents in France and beyond.

KEYWORDS:

• hepatitis B
• hepatitis B epidemiology
• hepatitis B immunization
• immunization delay
• France

Disclosure of potential conflicts of interest

Drs. Kane, Roudot-Thoraval, and Guerin have no conflict of interest or financial interests in the subject of this editorial.

Dr. Van Damme: PVD acts as coordinating and principal investigator for vaccine trials conducted on behalf of the University of Antwerp, for which the University obtains research grants from vaccine manufacturers; speakers fees for presentations on vaccines are paid directly to an educational fund held by the University of Antwerp. PVD receives no personal remuneration for this work.

Dr. Papaevangelo: VP has received research grants from vaccine manufactures and speakers fees for presentations on vaccines which are directly paid to the special account for research grants of the National and Kapodistrian University of Athens.