Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link

Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.

Volume 28, Supplement—December 2022

Effects of Decreased Immunization Coverage for Hepatitis B Virus Caused by COVID-19 in World Health Organization Western Pacific and African Regions, 2020

Hyacinte J. Kabore1Comments to Author , Xi Li1, Robert D. Allison, Tigran Avagyan, Richard Mihigo, Yoshihiro Takashima, and Rania A. Tohme
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (H.J. Kabore, X. Li, R.D. Allison, R.A. Tohme); World Health Organization, Brazzaville, Republic of the Congo (H.J. Kabore, R. Mihigo); World Health Organization, Manila, Philippines (T. Avagyan, Y. Takashima)

Main Article


Estimated numbers of chronic hepatitis B virus infections and related deaths after decreased hepatitis B vaccine birth dose and third dose vaccination coverage caused by COVID-19 in World Health Organization Western Pacific and African Regions, 2020*

Variables Baseline, 2019 Hepatitis B birth dose
Hepatitis B third-dose†
Decrease, 10% Decrease, 20% Decrease, 10% Decrease, 20%
Western Pacific Region
Hepatitis B birth dose coverage 84% 76% 67% NA NA
Hepatitis B third-dose coverage 94% NA NA 85% 75%
Chronic infections 332,179 368,521 404,863 529,976 727,773
HBV-related deaths
Hepatocellular carcinoma 29,779 33,392 37,004 49,394 69,009
Liver cirrhosis 31,002 34,538 38,075 50,589 70,175
Fulminant hepatitis 1,442 1,442 1,442 2,390 3,339

African Region
Hepatitis B birth dose coverage 17% 15% 14% NA NA
Hepatitis B third-dose coverage 73% NA NA 66% 58%
Chronic infections 1,564,688 1,574,481 1,584,273 1,815,712 2,066,735
HBV-related deaths
Hepatocellular carcinoma 81,267 81,805 82,342 94,405 107,543
Liver cirrhosis 112,011 112,651 113,290 130,895 149,779
Fulminant hepatitis 7,891 7,891 7,891 9,733 11,575
Total 201,170 202,347 203,524 235,033 268,897

*We assumed that in the absence of the COVID-19 pandemic, 2019 hepatitis B vaccination coverage levels would have been maintained in 2020; hepatitis B vaccination coverages for 2020 were estimated from 2019 baseline coverage levels, and baseline coverage levels were from World Health Organization/UNICEF estimates of national immunization coverage or derived from official or administrative estimates from specific countries. HBV, hepatitis B virus; NA, not applicable. †Hepatitis B third-dose coverage was a combination of a hepatitis B birth dose and 2 additional doses of hepatitis B vaccine in 14 countries in the Western Pacific Region. Other countries provided up to 3 additional hepatitis B doses in a pentavalent vaccine.

Main Article

1These authors contributed equally to this article.

Page created: August 11, 2022
Page updated: September 16, 2022
Page reviewed: September 16, 2022
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.