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     Hepatitis B
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» Group B - Governance and
   Accountability Indicators
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Supporting Documents
Initial Report on Public Health
Immunization Coverage of Hepatitis B
Narrative

The immunization coverage for hepatitis B indicator estimates the proportion of grade 7 students who have completed the immunization series against hepatitis B by the end of grade 7.

Hepatitis B is caused by a virus that attacks, and can permanently damage, the liver. It is the leading cause of liver cancer worldwide. 110 The highly contagious virus is spread through close contact with infected bodily fluids including blood. Unprotected sexual contact is the most common risk factor for hepatitis B infection in Ontario. 111 Sharing needles with an infected person is another risk factor for infection. 112

In Ontario, publicly funded hepatitis B vaccines are provided for specific populations including those at higher risk due to lifestyle, or due to being a contact, being a carrier, or having been diagnosed with an acute liver disease. In addition, a universal vaccination program is administered by public health units through a school-based program to students in grade 7. There is also a catch-up program for students in grade 8 who may have missed some or all of the vaccine series in grade 7.

Hepatitis B coverage among students is a unique indicator in that it speaks to the efficacy of a program over which public health units have direct control at the local level.

Public health units plan and deliver school-based hepatitis B immunization clinics. This indicator reflects the appropriate planning and delivery of school-based hepatitis B immunization clinics, public health unit efforts to educate parents and children and promote uptake of hepatitis B immunization, and public health unit data gathering with respect to hepatitis B immunization.

At the end of the 2007-2008 school year 79.8% of grade 7 students in Ontario completed the immunization series against hepatitis B. Based on 36 public health units in Ontario, the highest coverage was 95.2% and the lowest coverage was 65.2% of grade 7 students who completed the two-dose series against hepatitis B.

Indicator Definition

Definition:

The immunization coverage for hepatitis B indicator estimates the proportion of grade 7 students who have completed the immunization series against hepatitis B by the end of grade 7.

Data Source(s):

Numerator: As reported by public health units to Public Health Division, Ministry of Health and Long-Term Care
Denominator: As reported by public health units to Public Health Division, Ministry of Health and Long-Term Care

Formula:

# of grade 7 students who have completed the immunization series against hepatitis B by the end of grade 7 (vaccinated before or during grade 7 by physician or public health) (2007/2008 school year)

Total number of Grade 7 students (2007/2008 school year)
 
 
x 100

Notes:

  • Data as complete as of June 30, 2008 (2007/2008 school year) for grade 7 students (birth year 1995)
  • Hepatitis B immunization is not a designated disease under the ISPA (Immunization of School Pupils Act) and therefore health units are not required to report Hepatitis B immunization rates; reporting is voluntary
  • All public health units are required to report Hepatitis B coverage rates to the Ministry of Health and Long-Term Care. Some public health units also record Hepatitis B coverage rates in the IRIS reporting data system; use of this system is voluntary
  • This indicator is specific to the school-based immunization program, and does not include all immunizations against Hepatitis B as administered by the public health unit (e.g. doses administered in other setting or populations/age groups, such as sexual health clinics)

110 Zuckerman J, van Hattum J, Cafferkey M, et al. Should hepatitis B vaccination be introduced into childhood immunisation programmes in northern Europe? Lancet Infect Dis. 2007;7(6):410-9.
111 Tepper ML, Gully PR. Lovers and livers: Hepatitis B as an STD. Can J Hum Sexuality. 1997; 6(2): 135-142.
112 Piot P, Goilav C, Kegels E. Hepatitis B: transmission by sexual contact and needle sharing. Vaccine. 1990 Mar;8 Suppl:S37-40.

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