A Model HBV Catch-up Immunization and Education Project in Qinghai, China

Learning Objectives for this Presentation:
By the end of the presentation participants will be able to:
1. Identify strategies for educating Chinese students about hepatitis B.
2. Generate ideas for training public health officials and teachers in hepatitis B awareness and prevention.
3. Assess the effectiveness of catch-up vaccination and education.

Background:
Qinghai is a remote province in China with 70% ethnic minorities and low socioeconomic status. Although a national policy was introduced in 2005 to provide free newborn HBV vaccination, many children born before then remain unprotected. Many children and teachers have not been educated about HBV transmission and prevention, resulting in discrimination against those infected.

Setting:
HainanZhou district, Qinghai Province, where chronic HBV prevalence is 18%.

Population:
Provincial CDC staff, teachers and students.

Project Description:
This project had two components: vaccination and education. The goal was to provide free HBV catch-up vaccination for approximately 55,000 children in all 331 kindergarten and elementary schools. Vaccines were administered at the schools by trained doctors and nurses under CDC supervision. Trained project instructors led 45-minute classes at each school, using cartoon posters and an HBV song as teaching guides. A second educational phase took a hierarchical approach, beginning with the training of CDC staff, who then educated elementary school teachers, who in turn instructed their students, who took home a calendar with HBV information to teach their families. All participants took pre- and post-education knowledge surveys and received a “Jade Ribbon LIVERight” bracelet upon completion of the third vaccine dose.

Results/Lessons Learned:
Hepatitis B vaccine was administered to 54,680 students, with an unprecedented three-shot completion rate of 99.4%. Hepatitis B knowledge significantly improved. Educational materials in additional ethnic languages were needed. This model program has inspired the Qinghai government to expand the program to vaccinate 500,000 children in the remaining districts in 2007-2008.