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Perinatal Hepatitis B
Hepatitis B infection in a pregnant woman poses a serious risk to her infant at birth. Infants who become infected with hepatitis B virus (HBV) have a 90% risk for developing chronic HBV infection and a 25% lifetime risk for dying prematurely from cirrhosis or hepatocellular carcinoma. A key strategy to eliminate mother-to-child transmission of HBV is to prevent infants born to HBsAg-positive women from becoming infected. The Advisory Committee on Immunization Practices (ACIP) recommends post-exposure prophylaxis with hepatitis B immune globulin (HBIG) and hepatitis B vaccine within 12 hours of birth to all infants born to hepatitis B surface antigen (HBsAg)-positive women followed by completion of the hepatitis B vaccine series and post-vaccination serologic testing at 9-12 months of age. This approach has been shown to be 85%-95% effective in preventing HBV infection.
Preventing perinatal HBV transmission is an integral part of the national strategy to eliminate hepatitis B in the United States. National guidelines call for the following:
- Universal screening of pregnant women for HBsAg during each pregnancy
- Screening all HBsAg-positive pregnant women for HBV DNA to guide the use of maternal antiviral therapy during pregnancy. AASLD suggests maternal antiviral therapy when HBV DNA is >200,000 IU/m
- Case management of HBsAg-positive mothers and their infants
- Provision of immunoprophylaxis for infants born to infected mothers, including hepatitis B vaccine and hepatitis B immune globulin (HBIG)
- Routine vaccination of all infants with the hepatitis B vaccine series, with the first dose administered within 24 hours of birth
Click on the following links to find audience specific materials about perinatal hepatitis B:
Perinatal Hepatitis B Audiences
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Information for Pregnant Women & Mothers
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Hepatitis
B & Moms-to-Be (Pamphlet)
Pamphlet gives detailed information about hepatitis B infection during pregnancy and the steps to protecting infants. The pamphlet is available in multiple languages. Courtesy of the Asian Liver Center at Stanford University. - Protect Your Baby for Life (Pamphlet)
Pamphlet answers many of the common questions asked by hepatitis B-infected pregnant women. Courtesy of the Centers for Disease Control and Prevention. - Brief Introduction to Hepatitis B for Parents of Adopted Children
Information for parents who have adopted children that were born outside the US and their potential risk of hepatitis B infection. Courtesy of the Centers for Disease Control and Prevention. - Recommended Immunizations for Children from Birth Through 6 Years Old
An easy to read immunization schedule for parents that indicate what specific immunizations are due from birth to 6 years of age. Courtesy of the Centers for Disease Control and Prevention. - Hepatitis B Vaccine Information Sheet
Hepatitis B disease and vaccine information for the public and health professionals. Courtesy of the Centers for Disease Control and Prevention.
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Information for Prenatal Care Providers
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Serologic
Testing Requirements for Pregnant Women
(August 2022)
Quick reference flyer that outlines the serologic testing requirements for pregnant women in Georgia. Developed by the Georgia Department of Public Health. - Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices (January 2018)
Morbidity & Mortality Weekly Report (MMWR) from CDC that summarizes and consolidates previously published recommendations from the Advisory Committee on Immunization Practices (ACIP) and CDC. It also contains updates to recommendations for the prevention of HBV infection in the United States. - Testing for Hepatitis B Virus Infection During Pregnancy for Prenatal Providers
Flowchart for hepatitis B infection testing during pregnancy. Courtesy of the Centers for Disease Control and Prevention - Interpretation of Hepatitis B Serologic Test Results
Guide to interpreting and understanding hepatitis B serologic test results. Courtesy of the Centers for Disease Control and Prevention. - Physician's Guide to Hepatitis B (2020)
A physician's guide to diagnosing and treating hepatitis B infections. Courtesy of the Asian Liver Center at Stanford University. - Notifiable Disease Reporting Information
Guide for reporting notifiable diseases to the Georgia Department of Public Health. Includes list of notifiable diseases, case report form and contact information for county health departments. - Hepatitis B Vaccine Information Sheet
Hepatitis B disease and vaccine information for the public and health professionals. Courtesy of the Centers for Disease Control and Prevention. -
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Pediatric Guide: Caring for Infants Born to Hepatitis B Infected Mothers
(March 2018)
Quick reference guide that describes hepatitis B vaccination and testing for high-risk infants. The target audience for this publication is pediatric medical care providers. Developed by the Georgia Department of Public Health’s Perinatal Hepatitis B Prevention Program. - Epidemiology and Prevention of Vaccine-Preventable Diseases
This chapter discusses pathogenesis, clinical features, epidemiology, vaccination, and surveillance of hepatitis B.
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Information for Hospitals & Birth Clerks
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Serologic
Testing Requirements for Pregnant Women
(August 2022)
Quick reference flyer that outlines the serologic testing requirements for pregnant women in Georgia. Developed by the Georgia Department of Public Health. - Hepatitis B: What Hospitals Need to Do to Protect Newborns
Endorsed by AAFP, AAP, ACOG, and CDC, the Immunization Action Coalition's (IAC) comprehensive guidebook Hepatitis B: What Hospitals Need to Do to Protect Newborns is a complete resource for helping hospitals and birthing centers establish, implement, and optimize their birth dose policies. The book breaks new ground as a policy and best practices guide for newborn hepatitis B immunization. Courtesy of the Immunization Action Coalition. - Procedures to Prevent Perinatal Hepatitis B Virus Transmission at Delivery – HBsAg Lab Report Available
Algorithm for triaging infants born to women with reactive hepatitis B surface antigen (HBsAg) lab results. Courtesy of the Centers for Disease Control and Prevention. - Procedures to Prevent Perinatal Hepatitis B Virus Transmission at Delivery – HBsAg Lab Report Unavailable
Algorithm for triaging infants born to women with unknown hepatitis B surface antigen (HBsAg) lab results. Courtesy of the Centers for Disease Control and Prevention - Interpretation of Hepatitis B Serologic Test Results
Guide to interpreting and understanding hepatitis B serologic test results. Courtesy of the Centers for Disease Control and Prevention - Discrepant Hepatitis B Surface Antigen (HBsAG) lab results during pregnancy: recommended next steps: The CDC chart on discrepant Hepatitis B Surface Antigen (HBsAg) lab results during pregnancy provides a clear workflow for managing cases where initial and follow-up HBsAg lab results differ. It outlines the steps for clinicians, emphasizing retesting in cases of discordant results and verifying the test method and lab standards. The chart guides decisions based on confirmed HBsAg positivity or negativity, with additional steps for reporting and follow-up to prevent perinatal Hepatitis B transmission.
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Pediatric Guide: Caring for Infants Born to Hepatitis B Infected Mothers
(March 2018)
Quick reference guide that describes hepatitis B vaccination and testing for high-risk infants. The target audience for this publication is pediatric medical care providers. Developed by the Georgia Department of Public Health’s Perinatal Hepatitis B Prevention Program. - Guidance for Developing Admission Orders in Labor & Delivery and Newborn Units to Prevent Hepatitis B Virus Transmission
This is a sample of what hospital L&D units should include in their policy to prevent perinatal transmission of hepatitis B virus. Courtesy of the Immunization Action Coalition. - Sample Text for Developing Admission Orders in Newborn Units for the Hepatitis B Vaccine Birth Dose
This is a sample of what newborn units should include in their standing orders for hepatitis B vaccine birth dose administration. Courtesy of the Immunization Action Coalition. - Give the Birth Dose…Hepatitis B vaccine at birth saves lives
Information on the importance of administering the hepatitis B birth dose. Courtesy of the Immunization Action Coalition. - Hepatitis B Vaccine Information Sheet
Hepatitis B disease and vaccine information for the public and health professionals. Courtesy of the Centers for Disease Control and Prevention. - Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices (January 2018)
Morbidity & Mortality Weekly Report (MMWR) from CDC that summarizes and consolidates previously published recommendations from the Advisory Committee on Immunization Practices (ACIP) and CDC. It also contains updates to recommendations for the prevention of HBV infection in the United States. - Notifiable Disease Reporting Information
Guide for reporting notifiable diseases to the Georgia Department of Public Health. Includes list of notifiable diseases, case report form and contact information for county health departments. -
Perinatal
Hepatitis B Case Report Form
DPH form for reporting infants exposed to hepatitis B at birth. The form includes fields for reporting HBIG and hepatitis B vaccine administration dates and times. - Immunization Action Coalition's Hepatitis B Birth Dose Honor Roll
The Immunization Action Coalition (IAC) is recognizing hospitals and birthing centers that have attained 90% or greater coverage rates for administering hepatitis B vaccine at birth and have written policies aimed at protecting newborns. Facilities that meet these criteria can apply to IAC’s national Hepatitis B Birth Dose Honor Roll.- Click here to apply for IAC's Hepatitis B Birth Dose Honor Roll
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Information for Pediatric Providers
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Pediatric Guide: Caring for Infants Born to Hepatitis B Infected Mothers
(March 2018)
Quick reference guide that describes hepatitis B vaccination and testing for high-risk infants. The target audience for this publication is pediatric medical care providers. Developed by the Georgia Department of Public Health’s Perinatal Hepatitis B Prevention Program. - CDC Hepatitis B Provider Tip Sheet (September 2021)
Quick reference guide that provides guidance for managing infants born to women with hepatitis B infection. Courtesy of the Centers for Disease Control and Prevention. - Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices (January 2018)
Morbidity & Mortality Weekly Report (MMWR) from CDC that summarizes and consolidates previously published recommendations from the Advisory Committee on Immunization Practices (ACIP) and CDC. It also contains updates to recommendations for the prevention of HBV infection in the United States. - Morbidity and Mortality Weekly Report (MMWR): Shortened Interval for Postvaccination Serologic Testing of Infants Born to Hepatitis B-Infected Mothers
The CDC published a Morbidity and Mortality Weekly Report (MMWR) on October 9, 2015 recommending shortening the interval for post-vaccination serologic testing (PVST) from age 9–18 months to age 9–12 months. The recommendation to shorten the interval is a result of the discontinuation of the combination Hib/HepB vaccine (Comvax) and new data that show lower detectable levels of anti-HBs were associated with increased intervals between receipt of the last vaccine dose and post-vaccination serologic testing. - Hepatitis B Vaccine Information Sheet
Hepatitis B disease and vaccine information for the public and health professionals. Courtesy of the Centers for Disease Control and Prevention. - Notifiable Disease Reporting Information
Guide for reporting notifiable diseases to the Georgia Department of Public Health. Includes list of notifiable diseases, case report form and contact information for county health departments - Pink Book Hepatitis B Chapter
The Pink Book provides physicians, nurses, nurse practitioners, physician assistants, pharmacists, and others with the most comprehensive information on vaccine-preventable diseases.
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Additional Resources
- Georgia Department of Public Health: Viral Hepatitis
Website dedicated to viral hepatitis in Georgia. Educational resources are available. - Centers for Disease Control and Prevention
Link to educational materials written by the CDC’s Division of Viral Hepatitis for mothers and parents of children that will be or have been exposed to hepatitis B. - HepB Moms
Resource for hepatitis B positive women. Materials are available in multiple languages. - Immunization Action Coalition
Website for both providers and parents regarding perinatal hepatitis B prevention and hepatitis B vaccine. - Hepatitis B Foundation
This nonprofit hepatitis B website addresses commonly asked questions concerning hepatitis B. - Asian Liver Foundation
Nonprofit hepatitis B foundation that addresses HBV in the Asian community. - State Electronic Notifiable Disease Surveillance System (SENDSS)
Notifiable diseases and health conditions can be reported through DPH's electronic disease surveillance system. - Georgia Registry of Immunization Transactions and Services (GRITS)
The Georgia Immunization Registry collects and maintains vaccination records.
- Georgia Department of Public Health: Viral Hepatitis
GA PHBPP Contact Info
Page updated 10/30/2024