欧洲疾控中心-欧盟和欧洲经济区实现消除肝炎的乙肝疫苗接种政策_做法和挑战（英）-2025_22页_997kb

Summary of Hepatitis B Vaccination Policies, Practices and Challenges in the EU/EEA

Core Content

This report, published by the European Centre for Disease Prevention and Control (ECDC), provides an overview of hepatitis B virus (HBV) vaccination policies, practices, and challenges in the European Union (EU) and European Economic Area (EEA). It highlights progress and gaps in achieving the WHO 2025 interim targets for HBV elimination.

Key Findings

1. HBV Prevalence and Burden

• An estimated 3.2 million people in the EU/EEA live with chronic HBV infection.
• The overall prevalence of HBV infection in the region is below 1% in most countries, but remains above 2% in some.
• High prevalence is observed among key populations such as:
  • People who inject drugs (0.4–16.9%)
  • Men who have sex with men (2.3–4.3%)
  • People in prison (0.3–8.3%)
  • Migrant populations from high-endemicity regions

2. Acute HBV Notifications

• In 2023, 37,766 new HBV infections were reported across 30 EU/EEA countries, with 2,392 (6.3%) classified as acute.
• The notification rate for acute HBV infections was stable from 2014–2016, then declined sharply in 2020 (to 0.3 per 100,000).
• From 2020–2023, the notification rate increased for the first time since 2013, potentially due to:
  • Lifting of pandemic-related restrictions
  • Improved access to testing
  • Reporting factors
  • Changes in migration patterns

3. Transmission Routes

• The most common transmission routes in 2023:
  • Heterosexual contact (18.0%)
  • Nosocomial transmission (16.0%)
  • Injecting drug use (15.0%)
  • Men who have sex with men (14.7%)
• Mother-to-child transmission is rare in acute cases (1%) but significant in chronic cases (41%).
• Most chronic infections are imported from outside the country, indicating the importance of international cooperation.

4. HBV Vaccination Coverage

• 27 countries recommend universal childhood HBV vaccination.
• Coverage of three doses of HBV vaccine in 2023 ranged from 46% in Lithuania to 99% in Portugal.
  • 10 countries (40%) met the 95% coverage target.
  • 11 countries (44%) were within 10% of the target.
  • 4 countries (16%) had coverage at/below 85%.
• 5 countries provide a universal birth dose of HBV vaccine, with coverage above 90% in all.
• Coverage of birth dose among infants born to HBV-positive mothers is high in countries with targeted policies.

5. Key Populations and Vaccination Policies

• 29 countries reported policies for HBV vaccination among key populations.
• 20 countries (69%) have policies for healthcare workers.
• 18 countries (62%) have policies for men who have sex with men.
• 16 countries (55%) have policies for people who inject drugs.
• Only 12 countries (41%) have policies for people in prison.
• 9 countries (31%) have policies for migrant populations.
• 3 countries mentioned migrants from high-endemicity areas in the 'other' category.

6. Challenges

• Inconsistent vaccination coverage across countries and populations.
• Limited data on vaccination coverage among key populations.
• Decreased coverage in some countries, such as Estonia, Lithuania, and Romania, between 2019 and 2023.
• Public perception and vaccine misinformation may be contributing to parental hesitancy.
• Barriers to access and costs remain a challenge in some communities.

7. WHO 2025 Interim Targets

• HBsAg prevalence in vaccinated cohorts <0.5%
• 95% coverage of three doses of childhood HBV vaccine
• 90% coverage with timely birth dose (within 24 hours of birth)
• Prevention of vertical transmission through:
  • Antenatal screening for HBsAg
  • Post-exposure prophylaxis for infants of HBV-positive mothers
  • Timely administration of birth dose and hepatitis B immunoglobulin (HBIG) if needed

8. Recommendations

• Improve data collection and monitoring to better inform interventions.
• Enhance communication to address vaccine misinformation and increase public confidence.
• Tailor strategies to address low vaccination coverage in key populations.
• Ensure access to vaccination for all at-risk groups, including people in prison and migrants.
• Maintain high coverage in childhood vaccination programmes to prevent new infections.

Main Views

• HBV vaccination is a key strategy in reducing the burden of HBV-related diseases, including liver cirrhosis and hepatocellular carcinoma (HCC).
• The reporting and monitoring systems vary across countries, leading to inconsistent data.
• The WHO 2030 elimination targets are aligned with the 2025 interim targets, and achieving these is critical for public health.
• Public health efforts must focus on both childhood vaccination and targeted interventions for high-risk groups to reduce HBV transmission and incidence.

Key Information

• HBV vaccine is highly cost-effective and provides lifelong protection.
• Early vaccination (especially within 24 hours of birth) is crucial to prevent chronic infection.
• The 2025 interim targets include:
  • 95% coverage of three doses of childhood HBV vaccine
  • 90% coverage of timely birth dose
  • Prevention of vertical transmission
• Vaccination of healthcare workers is important for both personal protection and public health promotion.
• Parental hesitancy and pandemic-related disruptions may have contributed to declines in vaccination coverage.

Conclusion

Despite progress in HBV vaccination across the EU/EEA, challenges remain in achieving the 2025 WHO targets. Improving data collection, addressing misinformation, and ensuring equitable access to vaccination are essential for continued progress towards HBV elimination.