• Minal K Patel, Kathleen Wannemuehler, Rangi Tairi, Rufina Tutai, Edna Moturi, Beia Tabwaia, Akineti Bauro Nikuata, Malae Fepuleai Etuale, and Grizelda Mokoia.
• Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, United States. Electronic address: hgo9@cdc.gov.
• Vaccine. 2016 Aug 5; 34 (36): 4298-303.

BackgroundHepatitis B virus (HBV) is highly endemic in many of the Pacific Island countries. Four island countries-Cook Islands, Kiribati, Niue, and Tokelau-sought to evaluate the success of their hepatitis B vaccination programs by conducting nationally representative serosurveys among children born post-vaccine introduction.MethodsCook Islands, Niue, and Tokelau conducted school-based census serosurveys because of small populations. The Cook Islands tested children in second grade; Niue tested children in early childhood education through sixth grade; and Tokelau tested children in first through sixth grades. Because Kiribati has a much larger birth cohort, it conducted a one-stage stratified serosurvey among first grade students. All four countries tested children using the Alere Determine™ rapid point of care hepatitis B surface antigen (HBsAg) test.ResultsIn the three smaller countries, no children were seropositive for HBsAg (0/245 Cook Island students, 0/183 Niuean students, 0/171 Tokelau students). In Kiribati, 39 (3.3%, 95% confidence interval 2.4-4.6%) of 1249 students were HBsAg positive. Vaccination data collected in the Cook Islands and Tokelau showed high vaccination coverage in both countries with ⩾95% birth dose coverage and 100% 3-dose coverage.ConclusionsThe Cook Islands, Niue, and Tokelau have made remarkable progress in establishing strong vaccination programs and towards decreasing the burden of hepatitis B among children. Kiribati still needs to improve vaccination coverage to achieve the <1% HBsAg target established by the World Health Organization Western Pacific Region.Published by Elsevier Ltd.

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