This is a timetable of HBV vaccine program in Taiwan. The immunization program was launched in July first, 1980 for a first, due to the limitation of budget, the government decided to focus on the high-risk group. Only babies born to HBV carrier mothers received HPV vaccines. A few years later, the program was expanded from 1986 to present, all newborn babies received HPV vaccines, and from 1987 to 1990, preschool children to join in elementary school and junior and senior high school, or have the opportunity to be covered by vaccine program. This is a flow chart in Taiwan as prenatal and perinatal transmission play the most important role in no transmission of HPV in Taiwan. Pregnant woman asked for screening for HBs antigen. All HBs antigen-positive mother will be tested for HBe antigen if both HBs antigen and HBe antigen are positive, these mothers were classified as highly infectious mothers. Their babies will receive HBIG and three doses of HPV vaccines. And if HB antigen is negative, the HPV vaccines with our HBIG will be provided. However, the immunization policy in Taiwan was changed and expanded since July 2019, or implants bone to HBs antigen-positive mothers are provided with HBIG and three doses of HPV vaccines. Regardless of maternal HB antigens, data's. A series of serologic and epidemiological surveys were conducted in Taipei City every five years. By 1984, families table, we can see the prevalence rates of HBs antigen in children declined from 5 to 11 percent to below 1 percent up to 2013, Lavasa lesion coverage rate for infants is around 98 percent. Those who were born after the implantation of the universal HPV vaccination program had a much lower HBS antigen zero positive rate compared to those born before the implementation. Now owning Taiwan from his speaker, we can find that in other countries such as Thailand, Alaska, and Italy the prevalence of children with chronic HPV infection also gradually decrease after implantation of HPV vaccination program. In Taiwan, the mortality rate for Formula hepatitis in infants also decrease revolts after the implementation of the HPV vaccination and a trench was statistically significant. A study was also conducted to compare the incidence of HPV associated membrane, the hypocrisy before and after HPV vaccination program in Taiwan, they found the frequency decreased from 11.6 percent in 1974 to 1984, gradually to zero in 2004 to 2009. A well-known study conducted by Professor Meihua Jiao published on an EGM shows annual incidence of HCC children age 6 to 14 years in Taiwan decreased significantly after HPV vaccination program. Universal HPV immunization in Taiwan also effectively reduce acute hepatitis B occurrence. The impact of HPV immunization can also be found in Alaska. After 25 years of HPV immunization. The prevalence of HBs and agency repository rate in children below 20 years old decreased dramatically. There are no incidence of HCC in persons below 20 years in Alaska also decrease from three cases per 100,000 in 1984 to 1988, to zero case in 1998 to 1999 and no case has been found since 1999.Since there has been much debate about screening pregnant woman and the giving HBIG to newborns. All team analyze the rate of HBV infection amount to a children born to HBs antigen-positive mothers. Whether HBIG administration reduced transmission. We fought to children born to HBe antigen-positive mothers still have the greatest risk for chronic HPV infection. The risk is about 9.3 percent is by immunization. Under administration of HBIG into infants born to HBe antigen-negative mothers did not have any additional benefit to prevent a chronic HPV infection. Even though in order to reach the best protection, Taiwan government revised the immunization policy recently. HBIG are provided to all infants born to HBS antigen-positive mothers since July 1st, 2019, no matter HBe antigen-positive or negative. We hope more infants can be free from afraid of HBV infection. WHO recommends led all infants should received their first dose of HBV vaccine as soon as possible after birth and better within 24 hours after birth. Generally, more and more infants have been covered by HPV immunization globally. During 1989 to 2016, the number of countries introducing HPV vaccines and a third dose of HPV vaccine had stably increased. Currently, there are many three strategies of universal immunization programs in the world, depending on your resources and a prevalence of HPV infection in that country. In countries with less strategy one, such as USA, pregnant women are screened for HBs antigen but not HBe antigen. Every infant receive three doses of HPV vaccines and four laws infants HBs antigen and positive Mothers they receive HBIG within 24 hours regardless no status of HBe antigen. In countries with a strategy to, pregnant woman were screened for both serial HBs antigen and HBe antigen. HBIG is given to infants of mothers with positive HBs antigen and positive HB antigen. The best example is Taiwan. But since July 2019, Taiwan providing HBIG for all infants with HBs antigen-positive mothers regardless of HB antigens status. In countries with intermediate or lower prevalence of chronic HPV infection or [inaudible] resources then don't screen pregnant woman and all infants receive free doses of HPV vaccine. But not HBIG
