Hepatitis B in Russia

the RVF conducted a children's vaccination initiative against hepatitis B in the Russian Federation that became the largest public health program for children in Russia since the collapse of the Soviet Union.

In 1999 the Russian Ministry of Health (MOH) began vaccinating newborns against hepatitis B but lacked funding to vaccinate adolescents and health care workers at risk of contracting the disease. In early 2000 the Russian health authorities turned to the RVF for help in addressing this serious threat to public health.

From its inception in 2000 as a regional program in central Russia, the RVF vaccination initiative grew over the next six years to include 22 regions stretching from European Russia across Siberia to the Russian Far East. Other donors joined USDA in financing the effort, including the energy giant BP, the Norwegian Government, and USAID.

From the beginning the enduring strategic goal of the RVF vaccination initiative has been to reduce the number of unvaccinated children in each region to a level that could be managed and financed with local and national resources within three years. This required close collaboration between the RVF and national and local health authorities. Thus each regional vaccination program was designed jointly by local epidemiologist and RVF staff with the aim of strengthening the existing health care infrastructure and avoiding the creation of parallel structures. Staff training and public awareness campaigns were undertaken. Locally manufactured refrigerators and thermal containers for the safe storage and distribution of vaccine were distributed to facilities with outdated equipment. Close monitoring of record keeping and timely vaccine distribution was carried out jointly by RVF and local health officials. Wherever possible, adolescents were vaccinated in their schools, which typically results in average coverage rates in excess of 95%. As a comparison, Western immunization programs are considered successful if they achieve a coverage rate of 90%.

In May 2006 the RVF marked the completion of a nationwide vaccination program in the Russian Federation against hepatitis B for adolescents, institutionalized orphans and at risk health workers. Over 1.8 million children and nearly 100,000 at-risk health care workers were vaccinated in an initiative that encompassed 22 regions from Kaliningrad bordering Poland in the farthest western corner of the country to Primorsky along the Pacific Ocean in the Russian Far East. Now the Russian Ministry of Health and Social Development is financing this important work with its own resources.

The announcement by the Russian MOH that it will assume full financial responsibility for vaccinating all 13-year-olds throughout Russia against hepatitis B in 2006 is a clear affirmation of the VRF vaccination initiative as a model of a sustainable public health program.

Under the national Health Project, a total of 10 million school children were subject to vaccination against hepatitis B in Russia in 2006 and a total of 15 million children will be vaccinated against hepatitis B in 2007. As of March 2007, a total of 9.3 million people were vaccinated, which equates to a coverage rate of 93.5%. As a result, the incidence rate has dropped by 18.3%. For all of 2007 a total of 16.5 million people are subject to vaccination (including 1.5 million newborns and 15 million people aged 18-35 years of age).

The success of the RVF model is not limited to Russia. With additional financing from the U.S. government, the RVF has been able to launch similar children's vaccination programs in Azerbaijan and Georgia to protect hundreds of thousands of children in these countries against vaccine-preventable diseases.