What is the Perinatal Hep B Program?
The Perinatal Hep B program works with families and physicians to identify cases and ensure that at-risk children will not be infected with Hepatitis B virus (HBV). We ensure that all pregnant residents of Philadelphia are screened for Hepatitis B. Additionally, we ensure that all infants born to HbsAg-positive mothers receive immuno-prophylaxis and post-immunization screening for Hepatitis B as recommended by the Advisory Committee on Immunization Practices and the American Academy of Pediatrics.
By immunizing all who are susceptible to Hepatitis B, and educating the public and health care providers about Hepatitis B and its prevention, we aim to eliminate perinatal transmission of Hepatitis B.
All HbsAg-positive pregnant women and their infants and sexual and household contacts are eligible for screening and services.
Perinatal Hep B Program Services
The Perinatal Hepatitis B Program offers the following services to HbsAg-positive pregnant women and their infants and sexual and household contacts:
- Contact identification and education.
- Home visits by public health nurse to HbsAg-positive women and contacts for health education and case management.
- Referral to medical providers for screening and immunization of contacts and medical management of HbsAg-positive.
- Drawing blood for serologies in the home form contacts who can’t or won’t accept care at a medical care facility.
- Giving Hepatitis B vaccine to susceptible contacts and other vaccines to children whose immunizations are delayed, in the home if necessary.
- Medical consultation with Infectious Disease specialist on Hepatitis B for primary medical care providers. In-service education programs on Hepatitis B providers of prenatal, obstetric, neonatal and pediatric care.
To prevent perinatal Hepatitis B to new born infants we recommend the following at birth:
- Administer monovalent Hep B vaccine to all newborns before hospital discharge.
- For infants born to Hepatitis B surface antigen (HBsAg)-positive mothers, adminsiter HepB vaccine and 0.5 mL of Hepatitis B immune globulin (HBIG) within 12 hours of birth. Administer HepB vaccine at 1 month (dose 2) and 6 months of age (dose 3). These infants should be tested for HBsAg and antibody to HBsAg (anti-HBs) at 9 – 12 months of age (preferably 9 months).
- If mother’s HBsAg status is unknown, within 12 hours of birth administer HepB vaccine regardless of birth weight. For infants weighing less than 2,000 grams, administer HBIG in addition to HepB vaccine within 12 hours of birth. Determine mother’s HBsAg status as soon as possible and, if mother is HBsAg-positive, also administer HBIG for infants weighing 2,000 grams or more as soon as possible, but no later than age 7 days.
- The recommendations for infants with low birth weight (<2,000 grams) can be found in the next section.
Low Birth Weight Hepatitis B Prevention
Preterm infants with low birth weight (<2,000 grams) born to HBsAg positive women and women with unknown HBsAg status must receive immunoprophylaxis with HBV and HBIG within 12 hours of birth. Preterm infants of low birth weight whose mothers are laboratory-confirmed HBsAg negative can receive the first dose of the HBV series at chronologic age 1 month. Preterm infants discharged from the hospital before chronologic age 1 month can also be administered HBV at discharge if they are medically stable and have gained weight consistently. The full recommended dose should be used. See the table below for the full recommendation.