Hepatitis B Reporting

Under Vermont law, all cases of hepatitis B infection, including those in pregnant people with positive test results, must be reported to the Vermont Department of Health. To report a suspected or confirmed case of hepatitis B in a pregnant person, please contact the Perinatal Hepatitis B Coordinator at the Health Department's Infectious Disease Epidemiology Program. The contact numbers are 802-863-7240 or, for calls within Vermont, 800-640-4374.

Perinatal Hepatitis B Prevention Program

The Perinatal Hepatitis B Prevention Program works to identify the hepatitis B status of pregnant people, to communicate with those at high risk for transmitting hepatitis B infection to their infants, and to ensure access to the hepatitis B vaccine and hepatitis B immune globulin. The main goal is to reduce the incidence of hepatitis B in infants born to people with hepatitis B. The universal birth dose of the hepatitis B vaccine for ALL infants is recommended.

Hepatitis B virus (HBV) infection in a pregnant person poses a serious risk to their infant at birth. Without post-exposure immunoprophylaxis, up to 45% of infants born to an HBV-infected birthing person in the United States will become infected. Up to 90% of those infected will develop chronic, life-long HBV infection, approximately one-fourth of whom will eventually die from chronic liver disease. 

Perinatal HBV transmission can be prevented by identifying HBV-infected (i.e. hepatitis B surface antigen [HBsAg]-positive) pregnant people and providing hepatitis B immune globulin and hepatitis B vaccine to their infants within 12 hours of birth.

All pregnant people should be tested during an early prenatal visit with EACH pregnancy, even if tested before or previously vaccinated. 

If someone tests positive for hepatitis B during their pregnancy, the local District Office of the Vermont Department of Health will be notified, as will the perinatal hepatitis B coordinator who will notify the hospital. They will help make sure that the birthing parent and their baby receive the proper education, medication and vaccination to prevent the spread of hepatitis B during the birth.

PVST panels for infants born to HBV infected birth parent | CDC

If the series is delayed, blood work and post-vaccine serology (PVST) should occur between 9–12 months of age or 1–2 months after vaccine series completion. 

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Treatment Schedule for High-Risk Babies Born to a Birthing Person who is Hepatitis B+ or Unknown Hepatitis B status

All infants should receive a dose of hepatitis B vaccine at birth regardless of the HBV infection status of the birth parent. This birth dose, along with hepatitis B immune globulin (HBIG), serves as postexposure immunoprophylaxis for infants born to a parent with HBV infection. 

Birth Parent is HBsAg-Positive
  • Birth dose (monovalent HepB vaccine only): administer HepB vaccine and hepatitis B immune globulin (HBIG) in separate limbs within 12 hours of birth, regardless of birth weight.
  • Birth weight <2000 grams: administer 3 additional doses of HepB vaccine beginning at age 1 month (total of 4 doses).
  • Final (3rd or 4th) dose: administer at age 6 months.
  • Test for HBsAg and anti-HBs at age 9–12 months. If HepB series is delayed, test 1–2 months after final dose. Do not test before age 9 months.
Birth Parent is HBsAg-Unknown 

If other evidence suggestive of maternal hepatitis B infection exists (eg, presence of HBV DNA, HBeAg-positive, or birth parent known to have chronic hepatitis B infection), manage infant as if the birth parent is HBsAg-positive.

  • Birth dose (monovalent HepB vaccine only):
    • Birth weight ≥2000 grams: administer HepB vaccine within 12 hours of birth. Determine birth parent’s HBsAg status as soon as possible. If the birth parent is determined to be HBsAg-positive, administer HBIG as soon as possible (in separate limb), but no later than 7 days of age.
    • Birth weight <2000 grams: administer HepB vaccine and HBIG (in separate limbs) within 12 hours of birth. Administer 3 additional doses of HepB vaccine beginning at age 1 month (total of 4 doses).
  • Final (3rd or 4th) dose: administer at age 6 months (minimum age 24 weeks).
  • If the birth parent is determined to be HBsAg-positive or if status remains unknown, test for HBsAg and anti-HBs at age 9–12 months. If HepB series is delayed, test 1–2 months after final dose. Do not test before age 9 months.
     

AAP Recommended Vaccine Schedule


Complete postvaccination serologic testing (PVST) at 9–12 months of age (or 1–2 months after final dose, if series delayed) by testing for ONLY hepatitis B surface antigen (HBsAg) and antibodies to hepatitis B surface antigen (anti-HBs). Do NOT test for antibodies to hepatitis B core antigen (anti-HBc).


PVST helps clinicians determine whether the child has developed immunity or has HBV infection.

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