Hepatitis: Ukrainian refugees should be offered vaccines and free treatment, says WHOBMJ 2022; 377 doi: https://doi.org/10.1136/bmj.o1132 (Published 05 May 2022) Cite this as: BMJ 2022;377:o1132
Governments in Europe should provide free and accessible hepatitis care, as well as vaccinations, to Ukrainian refugees, the World Health Organization has said.1
In a joint statement with the European Association for the Study of the Liver and the European Centre for Disease Prevention and Control, the bodies highlight that hepatitis B virus and hepatitis C virus infections are key public health problems in Ukraine.
As of 10 April 2022, more than 4.5 million people had fled Ukraine, mainly to Hungary, Poland, Romania, Slovakia, and the Republic of Moldova, and from there people have moved to other European countries.
The statement called on European governments to be alert to potential cases, including by informing clinicians and healthcare workers of the need to consider timely testing for suspected cases of hepatitis.
It said hepatitis B vaccinations should be offered to children and adolescents with unknown vaccination status, known delayed, or missing vaccines, as well as to others with risk factors who do not have official records or evidence of immunity.
Hepatitis A vaccinations should be considered according to local guidelines, and close contacts of acute cases of hepatitis A infection should be traced and offered vaccination. If there is an outbreak of hepatitis A, rapid and widespread vaccination should be considered.
In 2020, the prevalence of hepatitis B surface antigen (HBsAg) was estimated at 1% in adults in Ukraine, while for hepatitis C (HCV-RNA positive) infection it was 3%. Prevalence was higher in men, in older people, among people who inject drugs, and in people living with HIV.
Ukraine’s vaccine coverage is lower than in most EU countries and below the recommended coverage target for elimination. In 2020, 80.9% of infants had received a third dose of the hepatitis B vaccine. There is currently no vaccine for hepatitis C.