Protecting Pregnant Women & Infants With Hepatitis B Vaccines

The US Preventive Services Task Force (USPSTF) reaffirmed its previous conclusion that there is convincing evidence that screening for the Hepatitis B virus (HBV) infection in pregnant women provides substantial benefit.

This USPSTF statement was published on July 30, 2019, saying there is adequate evidence that serologic testing for hepatitis B surface antigen accurately identifies HBV infections.

This means testing for the hepatitis B surface antigen (HBsAg) should be ordered at the 1st prenatal visit.

Additionally, women with unknown HBsAg status or with new or continuing risk factors for a viral infection of the liver should be screened at the time of admission to a hospital or other delivery setting, says the USPSTF.

And, the USPSTF found limited evidence on the harms of screening for HBV infection in pregnant women. But, the potential harms of HBV screening is small based on the high accuracy of screening and the low likelihood of harms from preventive interventions.

In addition, there is evidence that over time, a perinatal transmission has decreased among women and infants enrolled in case-management, providing an overall substantial health benefit.

Furthermore, the USPSTF found adequate evidence that vaccination of all infants against HBV infection and providing postexposure prophylaxis with hepatitis B immune globulin (HBIG) at birth to infants of mothers infected with HBV substantially reduce the risk for acquisition of HBV infection in infants.

This new USPSTF statement is important since in the USA, estimates of chronic HBV infection range from approximately 850 ,000 to more than 2 million cases. In 2016, a total of 3,218 cases of acute hepatitis B were reported to the US Centers for Disease Control and Prevention (CDC).

In the United States, the most prevalent cases of HBV infection are chronic infections from exposure occurring in infancy or childhood.

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Another major risk factor for HBV infection is country of origin. In the United States, adults with HBV born in high-prevalence countries were commonly infected during birth. 

In US-born children, the primary source of infection is vertical transmission at birth. According to the CDC, 800 to 1000 cases of perinatal transmission (3.8% of infants born to HBV-positive women) occurred yearly from 2000 to 2009.

Since 1998, rates of maternal HBV infection have increased annually by 5.5 percent. Older maternal age, race/ethnicity (non-Hispanic black and Asian populations), lower education, higher poverty levels, and lack of insurance coverage are risk factors for HBV infection among women.

Persons infected with HBV during infancy or childhood are more likely to develop chronic HBV infection and have poor long-term health outcomes compared with persons infected later in life.

Acute HBV infections progress to chronic disease in 80 to 90 percent of infected infants, 30 percent of acute infections progress before age 6 years, and less than 1 to 12 percent of acute infections progress in older children or adults.

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“Hepatitis isn’t a disease we hear about often, but it’s still prevalent despite being preventable. Hepatitis B vaccinations are recommended for children, but adults that did not receive the vaccines in childhood may still be at risk,” said Holly Hawbaker, Pharm D Candidate, Intern for Brookshires Grocery Company. 

“Patients should talk to their doctor or pharmacist to determine if they’re at risk for hepatitis, and if they are, they can receive the appropriate hepatitis vaccine.”

The CDC is sharing this 5-minute online assessment which offers a personalized report on hepatitis testing and vaccination recommendations.

The CDC said online on July 3, 2019, the ‘best way to prevent hepatitis B is by getting vaccinated. The hepatitis B vaccine is safe and effective. Completing the series of shots is needed for full protection.’ 

In the USA, there are 3 single-antigen vaccines and 2 combination HBV vaccines available:

Single-antigen hepatitis B vaccines: ENGERIX-B, RECOMBIVAX HB, and HEPLISAV-B

Combination vaccines: PEDIARIX and TWINRIX

To schedule a vaccination appointment at a local healthcare provider, please click here. And, vaccine financial support programs can be found at Vaccine Discounts.

Any vaccine can cause a side effect, which should be reported to a healthcare provider or the CDC.