Hepatitis B vaccine support

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All Gavi-supported countries have introduced hepatitis B vaccine as part of the five-in-one pentavalent vaccine

Threefold increase in hepatitis B vaccine coverage in Gavi's first decade


Spectacular acceleration

The very first hepatitis B vaccines funded by Gavi were administered to over one million babies in Mozambique in 2001.

Thanks to Gavi's new and underused vaccine support, many other low-income countries quickly introduced the vaccine, spurring a spectacular acceleration of hepatitis B immunisation coverage.

By 2004, 50% of low-income countries had included hepatitis B vaccines in their routine immunisation programmes. This occurred 22 years after the very first introduction in Italy – but only six years after high-income countries had reached the same 50% threshold.

By the end of 2014, all low-income countries had introduced the vaccine into their routine immunisation programmes.

Second Gavi Evaluation Report

Gavi's second evaluation report (2010) shows that the average number of country introductions per year of hepatitis B vaccines increased by three-fold following the introduction of Gavi support. Over 80% of countries reached peak coverage within two years of vaccine introduction.  

The report concludes that fewer countries would have introduced these vaccines in the absence of Gavi.

The easy-to-administer five-in-one pentavalent vaccine, which also protects children from diphtheria-tetanus-pertussis (DTP) and Haemophilus influenzae type b, has played a significant part in the increase of hepatitis B vaccine uptake.

China's dramatic fall in hepatitis B infections

A decade ago, barely 40% of children in China’s poorest areas were immunised against hepB. Today, after an eight year partnership between China and GAVI, only 1% of under 5’s are chronic carriers of hepB.

Read more

China Hepatitis B video screenshot

By the late 1990s, the hepatitis B vaccine had been on the market for two decades, but was not reaching enough poor countries

Kill or cure - Hepatitis B
Part of a series produced for BBC World, air date 28.06.2004.
Season 1 Episode 4.

Disease burden

Vaccinating against hepatitis B is an important investment in a country's future. While infections occur mostly in young children, the deadly consequences of the virus usually strike later in life as liver disease, including cirrhosis and liver cancer.

An estimated 240 million people worldwide are chronically infected with the hepatitis B virus, which claims approximately 700,000 lives every year due to acute or chronic liver disease.

Transmission of the virus from mother to newborn infant is a major contribution to disease in regions such as Asia and the Pacific Rim, where infection is widespread.

Hepatitis B claiming 900,000 lives in 2000

By the late 1990s, the hepatitis B vaccine was taking longer than the average 15 years usually required for a new vaccine to reach large numbers of the world's poorest children.

Hepatitis B vaccines had become available in 1981, with Italy becoming the first high-income country to introduce the vaccine into its national immunisation programme only a year later.

Yet it was only in 1985 that Zimbabwe became the first developing country to follow WHO's 1992 recommendation that childhood hepatitis B vaccination be included in all immunisation programmes

By 2000, the infection was claiming an estimated 900,000 lives each year, most of them in developing countries. Yet only 22 low-income countries had access to the hepatitis B-containing vaccine.

Gavi supports hepatitis B vaccines as part of the five-in-one pentavalent vaccine

As soon as Gavi was established in 2000, hepatitis B vaccine became one of three underused vaccines immediately made available for routine infant immunisation.


Initially, Gavi provided support for hepatitis B monovalent vaccine. However, in December 2005, the Gavi Board decided only to accept new applications for hepatitis B vaccine support through combination vaccines (tetravalent and pentavalent)

The five-in-one pentavalent vaccine, administered in a three-dose schedule, offers countries the added incentive of providing protection from hepatitis B at the same time as immunising their children against four other diseases: diphtheria, tetanus, pertussis (DTP3) and Haemophilus influenzae type b (Hib).

Pentavalent also brings savings in cost of equipment, delivery and disposal programmmes.

Map of countries approved for Gavi's Hepatitis b vaccine support

Countries approved for HepB support 

WHO recommendations on hepatitis B vaccines

1991: routine immunisation worldwide

2004: first dose within 24 hours of birth in countries where a high proportion of infections acquired perinatally

+215 million

By the end of 2014, 15 countries in the African meningitis belt had collectively immunised more than 215 million people against meningitis A with support from Gavi.

WHO 2014

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