A number of policy changes are needed to meet our elimination targets.
In May 2016, Canada signed on to the World Health Organization (WHO)’s first ever Global Viral Hepatitis Strategy, with the goal of eliminating viral hepatitis as a public health threat by 2030. With vaccines and treatments available, and a cure being explored, hepatitis B elimination is possible.
Prevalence:
Prevalence:
- 257 million people are estimated to be living with hepatitis B (HBV) globally.
- There are an estimated 250,000-460,000 people in Canada living with chronic HBV infection. [source]
- Despite the introduction of a universal childhood vaccination program in the 1990s, HBV continues to be a major cause of morbidity and mortality in Canada. [source]
- Populations in Canada that are disproportionately affected by hepatitis B include immigrants and newcomers, Indigenous people, people who inject drugs, men who have sex with men (MSM), people who are street involved or homeless, and those who have been incarcerated. [source]
1. Birthdose vaccination
|
Hepatitis B is a vaccine-preventable disease.
The World Health Organization recommends that all infants be vaccinated within 24 hours of birth. While all Canadian provinces and territories offer the vaccine, currently the policy on ages varies widely, from birth to 12 years. Action Hepatitis Canada calls on to the provinces and territories to adopt a uniform policy of infant vaccination against hepatitis B. |
|
Infant vaccination is especially important as over 90% of infants who become infected will develop chronic hepatitis B, compared to 5% of adults (95% of adults will clear their hepatitis B infections spontaneously).
Map of Canada showing the age the first dose of HBV vaccine is offered. Note: Alberta changed from 10y to 2m in 2019. The WHO recommendation is within 24 hours of birth.
Implementing infant vaccination consistently across Canada is the #1 way to bring the number of new infections in children close to zero.
2. Evidence-based screening guidelines
|
The Canadian Task Force on Preventive Health Care (CTFPHC) currently does not have screening guidelines for HBV, leaving healthcare practitioners to rely on a patchwork of inconsistent, often confusing, risk-based, provincial/territorial guidelines.
Evidence-based screening guidelines are an important tool in engaging primary healthcare providers in the early diagnosis of viral hepatitis and the elimination of viral hepatitis as a public health threat by 2030. On January 24, AHC, along with CanHepC, CanHepB, the Canadian Liver Foundation, and 26 other signing organizations, sent a letter to the CTFPHC requesting a review of their 2017 HCV screening guidelines and pointing out the need for HBV screening guidelines in Canada. |
3. Adult Hepatitis B Vaccinations
Data indicates that the highest rates of new chronic HBV infections are occurring in adults 30-39.
The US produced updated recommendations for adult HBV vaccinations in May 2022. With similar prevalence rates, this is a logical policy ask in Canada as well. Standardizing the provincial recommendations for adult vaccinations could greatly improve HBV prevention efforts.
The US produced updated recommendations for adult HBV vaccinations in May 2022. With similar prevalence rates, this is a logical policy ask in Canada as well. Standardizing the provincial recommendations for adult vaccinations could greatly improve HBV prevention efforts.
Other Policy Considerations
Action Hepatitis Canada continues to investigate other policy barriers to HBV elimination. These include equitable access to HBV treatment, licensing of HBV point of care tests, and better data to inform elimination progress.
To learn more about hepatitis B, visit www.catie.ca/hepatitis-b.
To learn more about hepatitis B, visit www.catie.ca/hepatitis-b.