Journal of Vaccine Research 2024, Vol.14, No.6, 278-286 http://medscipublisher.com/index.php/jvr 282 4.3 Immunocompromised and special populations Some people need different vaccine plans because their immune systems are weaker: 1)People with HIV: Only 40~60% of people with HIV reach good protection levels after regular shots. Giving them double doses helps more, raising protection to around 80% (Chaiwarith et al., 2019). 2)Dialysis Patients: Hemodialysis patients often fail to achieve long-lasting immunity, with over 50% losing detectable anti-HBs levels within 1~2 years. Frequent boosters and high-dose regimens are necessary to maintain protection (Tsouchnikas et al., 2007). 3)Pregnant Women and Newborns: Babies born to mothers with HBV are at high risk. Giving newborns a birth-dose vaccine plus hepatitis B immunoglobulin (HBIG) right after birth can protect over 95% of them, even in places where HBV is common (Liu et al., 2019). The vaccine dose, timing, and your health all affect how long protection lasts. Adjusting vaccine plans, giving boosters, or using higher doses when needed can help keep more people safe. Scientists are still working to make vaccines even better and protect more people around the world. 5 Long-Term Outcomes of HBV Vaccination Programs Hepatitis B vaccination programs have made a big difference around the world. They have cut down HBV infections, slowed the spread of the virus, lowered serious liver diseases, and saved a lot of healthcare money. As more people get vaccinated, these good results will likely get even better. One day, we might even wipe out HBV as a major health problem. 5.1 Reduction in HBV prevalence and transmission Vaccination programs have caused big drops in HBV cases and virus spread, especially in places where HBV used to be very common. For example, Taiwan started giving HBV shots to all newborns in 1984. Ten years later, HBV infections in kids under five dropped from 10% to less than 1% (Chen et al., 2015). China saw the same trend. Before vaccination, 9.7% of young kids had HBV in 1992. After adding the vaccine to national programs, the rate fell to 0.3% by 2014 (Liu et al., 2019). In Africa, there are still some problems, but in cities where more kids get vaccinated, HBV rates have gone down a lot too (Wang et al., 2023). Besides lowering infection rates, vaccines also stop moms from passing HBV to their babies. Giving newborns a shot at birth plus hepatitis B immunoglobulin (HBIG) works really well. In Taiwan, mother-to-baby HBV transmission dropped from 16.9% to less than 2% after the program started (Kao, 2015). 5.2 Prevention of chronic HBV and liver diseases The HBV vaccine doesn't just stop infections. It also lowers serious liver problems like cirrhosis and liver cancer (HCC) (Lee et al., 2020). In Taiwan, after they started giving the vaccine to all babies, liver cancer cases in kids fell by 67% over 20 years (Kao, 2015). In Alaska, indigenous groups used to have a lot of HBV cases. After vaccination programs began, liver diseases in these groups dropped a lot too (Flores et al., 2022). In sub-Saharan Africa, where liver cancer is very common because of HBV, vaccines for babies also showed strong protection. A study in Gambia found almost no liver cancer in vaccinated kids (Gilca et al., 2013). Also, with fewer chronic HBV infections, fewer people end up with cirrhosis. This helps save hospital costs and reduces the suffering caused by late-stage liver disease. 5.3 Cost-effectiveness of universal vaccination HBV vaccination doesn't just help health. It also saves a lot of money. Studies show vaccination programs are very cost-effective, especially where HBV is common. In China, every dollar spent on the HBV vaccine saved about $14 in future medical bills (Wang et al., 2019; Liu et al., 2020).
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