Despite global headway, Africa lags on eliminating mother-to-child HBV transmission

There has been some progress in eliminating mother-to child transmission of Hepatitis B. However, 26% have not yet introduced routine hepatitis B vaccinations to their citizens. These data are from the Data in Weekly Report on Morbidity and Mortality.

“Vaccinating newborns with hepatitis B vaccine within the first 24 hours of birth is essential for prevention mother-to-child transmission of hepatitis B virus,” Nino Khetsuriani, MD, PhD, an epidemiologist on the Hepatitis B and Tetanus Team at CDC’s Global Immunization Division, told Healio. “However, there are still 51 countries that do not provide the hepatitis B birth dose, most of them in the African region where the virus is widespread. Accelerating hepatitis B birth dose vaccine introduction in the remaining countries is needed to allow for all newborns in all countries access to the timely birth dose of hepatitis B vaccine and help eliminate mother-to-child transmission of hepatitis B virus globally.”

In the first review of progress toward elimination of hepatitis as a public health threat since it was first endorsed by the World Health Assembly in 2016, Khetsuriani noted that this report demonstrated the substantial progress made “and helped identify the gaps that need to be addressed to reach this goal”.

The report states that elimination of mother-to child transmission can be confirmed by children completing full HBV vaccinations and a prevalence of less than 0.1% HBV surface antigen among children under 5 years old.

“It is recommended that all newborns should receive a dose of hepatitis B vaccine at birth,” Khetsuriani told Healio. “Completion of a full series of hepatitis B vaccination by providing two or three additional doses offers lifelong protection against hepatitis B.”

Khetsuriani, colleagues and others reported that the global HBV vaccine coverage increased by 37% to 43% from 2016 to 2020.

From 99 countries reporting HBV vaccination coverage, 41% had at least 90% coverage by 2020. This includes both three-dose and birth doses. 11 countries had 0.1% or less HBV surface antigen prevalence in children as of 2021.

“The burden of hepatitis B is the highest in the WHO African Region where we see the lowest coverage with the hepatitis B birth dose vaccine,” Khetsuriani told Healio. “Access to on-time vaccinations, like hepatitis B birth dose, is a key pillar for improving health equity.”

She added that, “Ministries of Health should invest in screening and treatment of expectant mothers and establishing systems to monitor the implementation of preventive measures and vaccination of infants born to mothers living with hepatitis B. While vaccination is the most impactful strategy to advance efforts to eliminate HBV, screening and treatment of pregnant women are important the protect the health of the mother and the child.”