Mass Vaccination Campaign against Hepatitis B in Adolescents in Iran: Estimating Coverage using Administrative Data

Background and Aims: Hepatitis B vaccination has been part of the EPI of Iran since 1993. To extend HBV immunization to 25-year-old adolescents, HBV mass vaccination has been planned for adolescents born from 1989 to 1992. The first 3-round campaign in Iran covered 1989-born adolescents and was implemented in 2007. This study was conducted to estimate vaccination coverage of the campaign using administrative data at the provincial level.

Methods: To assess the campaign vaccination coverage we divided the number of adolescents vaccinated in the campaign by the total number of 17-year-old adolescents who resided in a given province. For the number of vaccinated cases we used administrative data as reported from universities of medical sciences and for the basic population we used the data from the last national population census (2007).

Results: After the 3 rounds of the campaign, a total of 3,983,291 doses of vaccine were administered. At the end of the third round, 70.0% (from 44.2% to 96.1% in various provinces) of the target population received full doses of the HBV vaccination. Moreover, 74.5% (51.3% to 99.9% in various provinces) received at least two doses and 78.3% (from 52.9% to 100% in various provinces) received at least one dose of the vaccine. Nineteen out of 30 provinces achieved acceptable full-dose coverage of higher than 70%. Low coverage (less than 50%) was reported from 3 provinces. Vaccination coverage was significantly higher in girls compared with boys (83.3% vs. 68.7% for full-dose coverage; P<0.001). In addition, vaccination coverage was significantly higher in rural areas than urban areas (84.1% vs. 68.7% for full-dose coverage; P<0.001).

Conclusions: The campaign reached acceptable coverage in the majority of the provinces. Higher coverage for women and rural areas, two known vulnerable populations in most health care systems, was attained within the campaign.