The incidence of acute hepatitis B cases in children and adolescents in the United States has declined in conjunction with an increase in hepatitis B vaccination coverage among children aged 19 to 35 months. In 1992 16% of such children received hepatitis B vaccination, and this increased to 90% in 2002. Among adolescents aged 13 to 15 years, vaccination increased from nearly zero in 1992 to 67% in 2002. However, the incidence of hepatitis B among adolescents aged 15 to 19 years was consistently higher than for the younger age groups, which is likely attributable to their having been born before universal infant hepatitis B vaccination was recommended in 1991. Incidence among older adolescents is expected to decline further as the vaccinated cohort ages and as 1999 recommendations to vaccinate all previously unvaccinated persons aged 0 to 18 years are fully implemented. The expected decline in rates among adolescents also might be augmented by laws in 32 states requiring proof of hepatitis B vaccination before entry into middle school. Despite the decline in acute hepatitis B cases among children in the US, the presence of confirmed cases highlights the importance of infant vaccination and timely completion of the 3-dose vaccination series. The vaccination series should be started at birth, preferably before the newborn is discharged from the hospital.
(Source: Morbidity and Mortality Weekly Report, Center for Disease Control and Prevention, Vol. 53, No. 43, 2004).
