Free hepatitis B vaccine runs out

Many hospitals across the country have run out of free hepatitis B vaccine for newborns, forcing parents to take their children to get vaccinated by private means.

Hepatitis B vaccine is included in the National Expanded Immunization Program, given to babies on the first day of life at the hospital. Vaccination centers and medical facilities also provide this vaccination service, but for a fee.

In fact, most children are given the first free injection within 24 hours of birth, then according to the schedule, at the ages of 2, 3, 4, 16-18 months, children need to be injected with additional combination vaccines containing hepatitis B components to achieve optimal protection.

The free hepatitis B vaccine is the recombinant vaccine Gene-HBvax, produced by Vabiotech Vaccine and Biological Company No. 1 under the Ministry of Health . On September 28, a representative of the Ho Chi Minh City Center for Disease Control said that this type had run out since the beginning of September, waiting for the Central Institute of Hygiene and Epidemiology (Ministry of Health) to supply. This is also the common situation in the provinces and cities, because there is only one source of supply from the Institute.

According to a vaccine expert (who did not want to be named), due to problems in procurement bidding, it is impossible to order and supply, and there is currently no hepatitis B vaccine left to distribute to provinces and cities. The Ministry of Health and related units are urgently resolving the problems, and it is expected that by November the supply will be restored.

"However, if the mother has hepatitis B and the baby is not vaccinated early, the risk of the baby being infected is very high," said this expert. There is no vaccine to be injected within 24 hours after birth, the baby will have to wait until it is two months old to be vaccinated with a combination vaccine that includes hepatitis B. This makes many families worried. Many people take their babies to a service vaccination point to get the hepatitis B vaccine, then take them back to the maternity hospital to stay with the mother.

For example, on September 27, Ms. Hoai, 58 years old, took her one-day-old grandchild to the VNVC Son Tay Vaccination Center ( Hanoi ) for vaccination. She said that her grandchild was born at Son Tay General Hospital, and the hepatitis B vaccine was out of stock, so medical staff advised the family to take the baby for a free vaccination. "I was worried that my baby would not have protective immunity after being vaccinated late, so after the umbilical cord was cut and her health was stable, I took her for vaccination immediately," she said. After the vaccination, she took her grandchild back to the maternity hospital to breastfeed.

Hepatitis B vaccination for newborns, at VNVC. Photo: Provided by the Center

The VNVC vaccination system in many localities has recorded a 50% increase in the number of newborns and pregnant women coming to get the hepatitis B vaccine service in recent days, "due to the shortage in other places".

Doctor Bach Thi Chinh, Medical Director of the VNVC Vaccination System, said "24 hours after birth is the golden time to vaccinate children against hepatitis B to prevent hepatitis B virus infection and liver cancer," adding that this is the recommendation of the World Health Organization and the Ministry of Health.

Vietnam is in a region with a high prevalence of hepatitis B (about 10-20% of the population). The rate of hepatitis B virus carriers in pregnant women is 10-16%, in children 2-6%. About 30% of people with chronic hepatitis B will progress to cirrhosis, 5-10% will progress to liver cancer. More than 60% of people with liver cancer have a history of hepatitis B.

According to Dr. Chinh, the injection within 24 hours after birth can prevent 85-90% of the risk of transmission from mother to child, and at the same time protect the child from other routes of hepatitis B transmission. If the injection is given late, the ability to prevent transmission from mother to child will decrease. Specifically, if the injection is given 7 days after birth, the ability to prevent infection from mother to child is only 50-57%.

If the mother has hepatitis B, in addition to vaccination, the baby also needs to be injected with hepatitis B immune serum within the first 12 hours after birth to neutralize antigens transmitted from the mother.

In acute hepatitis B infection, infants often have unclear and easily confused symptoms such as yellow urine, jaundice, poor feeding... affecting liver function. More than 90% of infants infected with hepatitis B will develop chronic hepatitis B in childhood or adulthood. Symptoms include jaundice, sluggishness, poor response, slow weight gain, bloating...

Doctors advise pregnant women to get vaccinated against hepatitis B during and before pregnancy to protect their babies. Women preparing to get pregnant need to get 3 shots within 6 months and complete the vaccination regimen at least one month before getting pregnant. If pregnant without getting 3 shots, pregnant women can continue to get vaccinated during pregnancy as directed by their doctor. In some developed countries, the prevalence of hepatitis is low, mother-to-child transmission is not the main route, but hepatitis B vaccination is also given very early, even within the first 12 hours after birth.

Since last year, the supply of many vaccines in the expanded immunization program has been interrupted, sometimes for many months, such as measles vaccine, DPT (combined vaccine to prevent diphtheria, whooping cough, tetanus), DPT-VGB-HiB (5-in-1 vaccine to prevent diphtheria, whooping cough, tetanus, hepatitis B, Hib pneumonia and Hib meningitis)...

The reason is due to some procedures related to purchasing regulations, including price. The shortage is more serious when according to new regulations, from 2023, the Ministry of Finance will not allocate budget for the Ministry of Health to buy, proposing to follow the regulations on budget decentralization, meaning that localities will buy to serve the needs of the provinces and cities. Not finding a source of supply, worrying about the difference in purchasing prices, many provinces and cities proposed that the Ministry of Health should continue to buy, the purchase money will be paid by the localities, but it was not approved.

Expanded Immunization Program is a national, free immunization program that protects children from a number of common and highly fatal infectious diseases such as tuberculosis, diphtheria, whooping cough, tetanus, polio, hepatitis B, measles, Japanese encephalitis, cholera, typhoid, pneumonia, and Hib meningitis.

Le Nga - Le Phuong

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