Hepatitis B vaccination: myths and controversies

Abstract

Hepatitis B has attracted a lot of attention in recent times. It has been suggested that it is a widely prevalent disease and an important cause of morbidity and mortality in our country. A dispassionate analysis of available data suggests that the prevalence of disease may be much less than believed hitherto, and the morbidity and mortality due to the disease may have been overestimated. Vertical transmission from mother to child at the time of delivery may be an important contributor to overall carrier rates in the community which warrants that the first dose of vaccine be administered within 24-48 hours of birth to all newborns. In view of this, the suggestion that Hepatitis B vaccine be incorporated in the National UIP also has many logistical difficulties, apart from a doubtful cost benefit ratio. This may therefore be not warranted at present. Also it would appear that the routine use of Hepatitis B vaccine in older individuals cannot be justified on epidemiological grounds in India and the widespread practice of holding camps for administering Hepatitis B vaccine to school children and other older citizens need to be re-examined.