Despite global headway, Africa lags on eliminating mother-to-child HBV transmission
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Although progress has been made in eliminating mother-to-child transmission of hepatitis B by 2030, 26% of countries have not introduced a birth dose into routine hepatitis B vaccination, noted data in Morbidity and Mortality Weekly Report.
“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”.
According to the report, elimination of mother-to-child transmission will be validated by a prevalence of no more than 0.1% of HBV surface antigen in children aged 5 years and younger and at least 90% of children worldwide completing a full HBV vaccination series.
“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.”
From 2016 to 2020, between 82% and 85% of the global population had received three HBV vaccine doses, and birth doses increased from 37% to 43%, Khetsuriani and colleagues reported.
Of 99 countries that reported HBV vaccination coverage, 41% reported at least 90% coverage in 2020 with both birth doses and the three-dose series. By 2021, 11 countries had reached 0.1% or less prevalence of HBV surface antigen in children.
“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.”
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