Global Immunization Division, US Centers for Disease Control and Prevention, Atlanta, United States.
Solomon Islands Ministry of Health and Medical Services, Honiara, Solomon Islands.
Vaccine. 2020 Jun 19;38(30):4679-4686. doi: 10.1016/j.vaccine.2020.05.029. Epub 2020 May 28.
The Western Pacific Region (WPR) established a goal to decrease chronic hepatitis B virus (HBV) infection among children to <1% and to achieve ≥95% hepatitis B vaccine birth dose (HepB-BD) and ≥95% three-dose (HepB3) coverage by 2017. In 2016, we conducted a national serosurvey in the Solomon Islands among 6-7-year-old school children to assess progress towards the control goal and immunity to measles, rubella, tetanus and diphtheria. Eighty schools were selected systematically proportional to their 6-7-year-old population; all 6-7-year-olds were enrolled. We collected basic demographic information and vaccination history. Children were tested for HBV surface antigen (HBsAg) using a rapid test, and for immunity to measles, rubella, tetanus, and diphtheria using a multiplex bead assay. In total, 1,249 out of 1,492 children (84%) were enrolled, among whom 1,169 (94%) underwent HBsAg testing and 1,156 (93%) provided dried blood spots. Almost 80% (n = 982) of enrolled children had vaccination cards, among whom 59% (n = 584) received a timely HepB-BD (within 24 hours of birth), 95% (n = 932) received HepB3, and >90% received vaccines for diphtheria, tetanus, and measles (rubella vaccine was not available at the time). HBsAg prevalence was 3.1% (95% confidence interval (CI): 2.0%-4.9%), with 55% of identified cases from one province. Among 982 children with vaccination cards, HBsAg prevalence was higher among children who had not received a timely HepB-BD and at least two HepB doses compared to those who had (4% vs. 2%). Of 1,156 tested children, immunoprotection estimates were 99% (95% CI: 98%-99%) for measles, 99% (95% CI: 97%-100%) for rubella, 85% (95% CI: 83%-87%) for tetanus, and 51% (95% CI: 47%-55%) for diphtheria. Improving timely HepB-BD coverage and maintaining high HepB3 coverage could help Solomon Islands reach the regional HBV control goal. Low immunity to tetanus and diphtheria suggests the need to introduce booster doses to ensure long-term protection.
西太平洋地区（WPR）制定了一个目标，即把儿童慢性乙型肝炎病毒（HBV）感染率降低到<1%，并在 2017 年实现乙肝疫苗基础免疫出生剂量（HepB-BD）接种率≥95%，以及三剂次（HepB3）接种率≥95%。2016 年，我们在所罗门群岛开展了一项全国血清学调查，对象为 6-7 岁在校儿童，以评估控制目标的进展情况以及麻疹、风疹、破伤风和白喉的免疫情况。我们系统地按照其 6-7 岁人口比例选择了 80 所学校；所有 6-7 岁儿童都被纳入调查。我们收集了基本人口统计学信息和疫苗接种史。使用快速检测法对儿童进行乙型肝炎表面抗原（HBsAg）检测，并用多重珠联免疫分析法检测麻疹、风疹、破伤风和白喉的免疫情况。共有 1492 名儿童中的 1249 名（84%）被纳入调查，其中 1169 名（94%）接受了 HBsAg 检测，1156 名（93%）提供了干血斑。近 80%（n=982）的入组儿童持有疫苗接种卡，其中 59%（n=584）及时接受了 HepB-BD（出生后 24 小时内），95%（n=932）接受了 HepB3，并且>90%接受了白喉、破伤风和麻疹疫苗接种（风疹疫苗当时不可用）。HBsAg 流行率为 3.1%（95%置信区间[CI]：2.0%-4.9%），其中 55%的病例来自一个省。在有疫苗接种卡的 982 名儿童中，与及时接受 HepB-BD 和至少两剂 HepB 相比，未及时接受 HepB-BD 和至少两剂 HepB 的儿童 HBsAg 阳性率更高（4%比 2%）。在接受检测的 1156 名儿童中，麻疹的免疫保护估计值为 99%（95%CI：98%-99%），风疹为 99%（95%CI：97%-100%），破伤风为 85%（95%CI：83%-87%），白喉为 51%（95%CI：47%-55%）。提高及时的 HepB-BD 接种率并保持高 HepB3 接种率可能有助于所罗门群岛实现区域 HBV 控制目标。破伤风和白喉免疫水平较低表明需要引入加强剂量以确保长期保护。
