The study modelled proposed changes to the US childhood hepatitis B vaccination schedule. The cohort was a single birth cohort of 3.6 million US-born infants. A Markov cohort state transition model ran over 20 years. It used maternal HBV prevalence of 0.4%, test sensitivity of 99.5% and age-stratified risk of chronic infection. Universal birth-dose vaccination gave 255 childhood chronic infections (95% UI 130 to 530). Deferred two-month vaccination raised this by 19% to 303. Shared decision making raised it by 83% to 467 (95% UI 209 to 1032). Susceptible people at year 20 rose from 232,000 to 474,000 and 1,806,000 respectively. The main limitation is uncertainty in the risk of horizontal HBV infection.
Why it is interesting: Quantifies the infection burden attached to a specific vaccination schedule change. Also reports how many children would enter adulthood susceptible to hepatitis B each year.
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