Implementation of hepatitis B birth dose vaccination – worldwide, 2016


Infections due to hepatitis B virus (HBV) are a leading cause of death worldwide. WHO estimated that in 2015, 257 million people globally were living with chronic HBV infection and that 887 000 deaths occurred due to HBV, mostly from longterm complications such as cirrhosis and hepatocellular carcinoma. The prevalence of chronic HBV infection among the general population ranges from >5% in most countries in the Western Pacific and African Regions, to <2% in most countries in the European and American Regions. In the majority of settings, chronic infections are commonly acquired at birth through perinatal transmission and in early childhood, when the risk of developing chronic infection is highest. HBV infection can be prevented by administration of the hepatitis B vaccine. WHO recommends at least 3 doses of hepatitis B vaccination for all children worldwide, with the first dose to be administered at birth.A birth dose of hepatitis B (HepBBD) should be given as soon as possible after birth and, if administered within 24 hours, is considered timely. A timely HepB-BD, followed by at least 2 additional doses in early infancy administered during the same visits as DTP-containing vaccine, prevents approximately 90% of perinatal infection. The effectiveness of HepB-BD in preventing perinatal transmission declines progressively in the days after birth; however, a late birth dose may still be effective, especially if given within 7 days after birth.In addition to preventing perinatal transmission, a HepB-BD can be effective in preventing horizontal transmission from household contacts during this vulnerable newborn period.