Lessons from Thailand's successful prevention of mother-to-child hepatitis B transmission: Advancing toward elimination by 2030.

Abstract

Thailand has achieved remarkable success in preventing and reducing hepatitis B virus (HBV) incidence through its nationwide newborn vaccination program, introduced in 1992 as part of the Expanded Program on Immunization (EPI). Before the vaccination era, HBV endemicity in Thailand was high, with a carrier rate of 6-8%, and mother-to-child transmission was a major route of infection. Early trials demonstrated the efficacy of hepatitis B vaccines, especially when administered within 12 hours of birth, followed by scheduled doses. The national vaccination program was initially piloted in two provinces in 1988 and expanded to full coverage by 1992. By 2024, carrier rates among children under 10 years dropped to less than 0.1%, meeting the WHO goal of zero mother-to-child transmission. Studies confirmed the vaccine's long-term protection, with no cases of chronic infection in vaccinated individuals with detectable anti-HBs over 20 years. Moreover, literature indicates that hepatitis B vaccination provides long-lasting protection more than 35 years. Additional measures, including antiviral use for high-risk mothers and expanded screening and treatment programs, have further supported HBV elimination. The program's impact has significantly reduced liver-related diseases and positioned Thailand as a model for HBV control. As the nation moves toward the 2030 hepatitis elimination goal, ongoing efforts focus on screening older populations with a high prevalence of infection and ensuring treatment access to achieve lasting eradication.