OBJECTIVE: To evaluate the effectiveness of the national programme for prevention of perinatal hepatitis B infections. SETTING: The regional public health laboratories and provincial immunization administrations in the Netherlands. DESIGN: Retrospective evaluation. METHODS: Starting October 1989 routine screening of pregnant women for HBsAg was performed and passive-active immunisation of infants of HBsAg-positive mothers was added to the national immunisation programme. Infants receive hepatitis B immunoglobulin at birth and hepatitis B vaccine at 3,4,5, and 11 months of age, concomitant with the DTP-polio vaccine. The effectiveness of screening and intervention in 1990 was evaluated. RESULTS: Screening covered about 85% of the pregnant population and the prevalence (0.44%) was less than expected. About 60% of the infants born to HBsAg-positive mothers were registered for vaccination. Of these infants the average coverage was 83% for immunoglobulin, and 90%, 86%, 80% and 55% for the four successive hepatitis B vaccinations. There was considerable delay in vaccine administration; frequently doses were administered later than recommended. CONCLUSION: Compliance with screening and vaccination appeared incomplete. Recommendations for the simplification of the current programme are made.
OBJECTIVE: To evaluate the effectiveness of the national programme for prevention of perinatal hepatitis B infections. SETTING: The regional public health laboratories and provincial immunization administrations in the Netherlands. DESIGN: Retrospective evaluation. METHODS: Starting October 1989 routine screening of pregnant women for HBsAg was performed and passive-active immunisation of infants of HBsAg-positive mothers was added to the national immunisation programme. Infants receive hepatitis B immunoglobulin at birth and hepatitis B vaccine at 3,4,5, and 11 months of age, concomitant with the DTP-polio vaccine. The effectiveness of screening and intervention in 1990 was evaluated. RESULTS: Screening covered about 85% of the pregnant population and the prevalence (0.44%) was less than expected. About 60% of the infants born to HBsAg-positive mothers were registered for vaccination. Of these infants the average coverage was 83% for immunoglobulin, and 90%, 86%, 80% and 55% for the four successive hepatitis B vaccinations. There was considerable delay in vaccine administration; frequently doses were administered later than recommended. CONCLUSION: Compliance with screening and vaccination appeared incomplete. Recommendations for the simplification of the current programme are made.