“Hepatitis B vaccination” in Iran: historical and ethical policies and programs
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Keywords

Health policy, Hepatitis B Virus, Vaccine, Iran

Abstract

Hepatitis B virus (HBV) infection is a main challenge of the health system worldwide. Health policymakers in most countries attempt to help HBV patients by implementing support programs in addition to controlling HBV in their community so that the economic burden caused by HBV do not deprive the patients of accessing health services and reducing their quality of life. The purpose of this study is to review the nature of HBV, its epidemiology in Iran and worldwide, and to review the various policies and programs in Iran regarding the prevention and control of HBV, especially the use of vaccination.

One of the goals of Sustainable Development Goals (SDGs) is to consider hepatitis as a threat to human health. In this regard, one of the top priorities of WHO is the prevention and control of HBV. In connection with the prevention of HBV, it is claimed that vaccination is the most effective and best intervention. Thus, vaccination in the safe’s program of countries is highly recommended. According to the Ministry of Health and Medical Education (MOHME) reports, Iran has the lowest prevalence of HBV among the countries in Eastern Mediterranean Region Organization (EMRO). There is a hepatitis unit in MOHME whose responsibility is to coordinate and implement the hepatitis prevention and control programs. The HBV vaccine has been officially included in the vaccination program for children in Iran since 1993, and three doses of the vaccine are given to all infants.  In 2007, during a large-scale program in Iran, 17-year-olds received the HBV vaccine, followed by adolescents born in 1990 and 1991. In recent years, the health system in Iran has made significant progress in preventing and controlling HBV. Over 95% coverage of the HBV vaccination is one of the achievements that have had a great impact on reducing the trend of HBV infection. In order to achieve the 2030 goals, the Iranian government, in addition to paying more attention to HBV elimination programs, should encourage other organizations to cooperate more effectively with MOHME.

https://doi.org/10.15167/2421-4248/jpmh2022.63.4.2731
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References

1. Kim SW, Yoon JS, Lee M, Cho Y. Toward a complete cure for chronic hepatitis B: Novel therapeutic targets for hepatitis B virus. Clin Mol Hepatol. 2022;28(1):17-30.
2. Rizzo GEM, Cabibbo G, Craxì A. Hepatitis B Virus-Associated Hepatocellular Carcinoma. Viruses. 2022;14(5):986.
3. World Health Organization. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021 2021 [updated 1 July 2021. Available from: https://www.who.int/publications/i/item/9789240027077.
4. Cardona-Arias JA, Correa JCC, Higuita-Gutiérrez LF. Prevalence of hepatitis B/C viruses and associated factors in key groups attending a health services institution in Colombia, 2019. PLoS One. 2020;15(9):e0238655.
5. Shemtob L, Ferris M, Asanati K. Hepatitis B Vaccination Booster for Healthcare Workers. Occup Med (Lond). 2022;72(1):55-6.
6. Flores JE, Thompson AJ, Ryan M, Howell J. The Global Impact of Hepatitis B Vaccination on Hepatocellular Carcinoma. Vaccines (Basel). 2021;10(5):793.
7. King H, Xing J, Dean HD, Holtzman D. Trends in Prevalence of Protective Levels of Hepatitis B Surface Antibody Among Adults Aged 18-49 Years With Risk Factors for Hepatitis B Virus Infection-United States, 2003-2014. Clin Infect Dis. 2020;70(9):1907-15.
8. Lu J, Xu A, Wang J, Zhang L, Song L, Li R, et al. Direct economic burden of hepatitis B virus related diseases: evidence from Shandong, China. BMC Health Serv Res. 2013;13:37.
9. Lin CL, Kao JH. Hepatitis B: Immunization and Impact on Natural History and Cancer Incidence. Gastroenterol Clin North Am. 2020;49(2):201-14.
10. Nayagam S, Thursz M, Sicuri E, Conteh L, Wiktor S, Low-Beer D, et al. Requirements for global elimination of hepatitis B: a modelling study. Lancet Infect Dis. 2016;16(12):1399-408.
11. Sperle I, Steffen G, Leendertz SA, Sarma N, Beermann S, Thamm R, et al. Prevalence of Hepatitis B, C, and D in Germany: Results From a Scoping Review. Front Public Health. 2020;8:424.
12. Behzadifar M, Gorji HA, Rezapour A, Behzadifar M, Bragazzi NL. The role of insurance providers in supporting treatment and management of hepatitis C patients. BMC Health Serv Res. 2019;19(1):25.
13. Jacob V, Qu S, Chattopadhyay S, Sipe TA, Knopf JA, Goetzel RZ, et al. Community Preventive Services Task Force. Legislations and policies to expand mental health and substance abuse benefits in health insurance plans: a community guide systematic economic review. J Ment Health Policy Econ. 2015;18(1):39-48.
14. Waheed Y. Transition from millennium development goals to sustainable development goals and hepatitis. Pathog Glob Health. 2015;109(8):353.
15. Raviglione M, Maher D. Ending infectious diseases in the era of the Sustainable Development Goals. Porto Biomed J. 2017;2(5):140-2.
16. Waheed Y, Siddiq M, Jamil Z, Najmi MH. Hepatitis elimination by 2030: Progress and challenges. World J Gastroenterol. 2018;24(44):4959-61.
17. hen S, Mao W, Guo L, Zhang J, Tang S. Combating hepatitis B and C by 2030: achievements, gaps, and options for actions in China. BMJ Glob Health. 2020;5(6):e002306.
18. Suthar AB, Harries AD. A public health approach to hepatitis C control in low- and middle-income countries. PLoS Med. 2015;12(3):e1001795.
19. Behzadifar M, Gorji HA, Rezapour A, Bragazzi NL. The hepatitis C infection in Iran: a policy analysis of agenda-setting using Kingdon's multiple streams framework. Health Res Policy Syst. 2019;17(1):30.
20. Razavi H. Polaris Observatory-supporting informed decision-making at the national, regional, and global levels to eliminate viral hepatitis. Antivir Ther. 2022;27(2):13596535221083179.
21. European Centre for Disease Prevention and Control. The sustainable development goals and hepatitis B and C in the EU/EEA 2021 [updated 2 July 2021. Available from: https://www.ecdc.europa.eu/en/publications-data/hepatitis-b-and-c-sustainable-development-goals-eu-eea.
22. Behzadifar M, Azari S, Gorji HA, Martini M, Bragazzi NL. The hepatitis C virus in Iran: health policy, historical, ethical issues and future challenges. J Prev Med Hyg. 2020;61(1):E109-E18.
23. Iran Hepatitis Network. Hepatitis in Iran 2019 [updated 3 July 2021. Available from: https://www.isna.ir/news/97073016857.
24. Rezaei N, Asadi-Lari M, Sheidaei A, Gohari K, Parsaeian M, Khademioureh S, et al. Epidemiology of Hepatitis B in Iran from 2000 to 2016: A Systematic Review and Meta-Regression Analysis. Arch Iran Med. 2020;23(3):189-96.
25. Behzadifar M, Gorji HA, Rezapour A, Rezvanian A, Bragazzi NL, Vatankhah S. Hepatitis C virus-related policy-making in Iran: a stakeholder and social network analysis. Health Res Policy Syst. 2019;17(1):42.
26. Behzadifar M, Gorji HA, Rezapour A, Bragazzi NL, Alavian SM. The role of the Primary Healthcare Network in Iran in hepatitis C virus elimination by 2030. J Virus Erad. 2018;4(3):186-8.
27. Lankarani KB, Alavian SM, Peymani P. Health in the Islamic Republic of Iran, challenges and progresses. Med J Islam Repub Iran. 2013;27(1):42-9.
28. Parija PP, M MK. Hepatitis B vaccine birth dose in India: time to reconsider. Hum Vaccin Immunother. 2020;16(1):158-60.
29. Zhao H, Zhou X, Zhou YH. Hepatitis B vaccine development and implementation. Hum Vaccin Immunother. 2020;16(7):1533-44.
30. Cho EJ, Kim SE, Suk KT, An J, Jeong SW, Chung WJ, et al. Current status and strategies for hepatitis B control in Korea. Clin Mol Hepatol. 2017;23(3):205-11.