Beuy Joob ( Sanitation Medical Academic Center, Bangkok Thailand. )
Viroj Wiwanitkti ( Visiting Professor, Hainan Medical University, China; Visiting Professor, Faculty of Medicine, University of Nis, Serbia; Adjunct Professor, Joseph Ayobabalola University, Nigeria. )
Madam, the recent report on "mother to child transmission of hepatitis B virus infection and hepatitis B immunization" is very interesting.1 Qureshi et al. concluded that "hepatitis B vaccination given at 6, 10 and 14 weeks of birth is not sufficiently protective, indicating a strong need for the introduction of birth dose into the national immunisation system."1 In fact, the birth dose of hepatitis B immunization has been used worldwide. In Thailand, the implementation of birth dose of hepatitis B immunization has been used for 20 years and the good protection could be observed.2 Similar observation is also reported from Taiwan.3 Hence, it is no doubt that the birth dose of hepatitis B immunization can also be useful and successful in case of Pakistan. However, the issues to be further studied including a) cost and utility analysis of implementation, b) the accessibility of vaccination service and c) the attachment to the vaccination programme. It might be expected that the main obstacles can be the cost of vaccine and attending to the standard delivery service of the pregnant.
1. Qureshi H, Javaid N, Alam SE, Bile KM. The evidence of mother to child transmission of hepatitis B virus infection in Pakistan and the need for hepatitis B immunization policy change. J Pak Med Assoc 2014; 64: 403-8.
2. Poovorawan Y, Chongsrisawat V, Theamboonlers A, Crasta PD, Messier M, Hardt K. Long-term anti-HBs antibody persistence following infant vaccination against hepatitis B and evaluation of anamnestic response: a 20-year follow-up study in Thailand. Hum Vaccin Immunother 2013; 9: 1679-84.
3. Su FH, Bai CH, Chu FY, Lin YS, Su CT, Yeh CC. Significance and anamnestic response in isolated hepatitis B core antibody-positive individuals 18 years after neonatal hepatitis B virus vaccination in Taiwan. Vaccine 2012; 30: 4034-9.