Perinatal Hepatitis B

This program provides support, education, and reminders to providers to ensure that all infants born to HBsAg-positive pregnant persons follow the CDC protocol to prevent contracting hepatitis B during delivery.

CLinical Guidance for Perinatal Hepatitis B Testing

The CDC recommends all pregnant persons be screened for hepatitis B virus during each pregnancy: Clinical Guidance for Perinatal Hepatitis B Testing | Hepatitis B | CDC

Under state law, providers must report HBsAg-positive pregnant persons to the Snohomish County Health Department within three working days as a notifiable condition.

To Report

  • Monday through Friday from 8 a.m. to 5 p.m. 
  • Phone 425-252-5439
  • Fax 425-339-8706

Perinatal hepatitis B Prevention Program Guidelines (PDF) is available online to assist prenatal providers, pediatricians, parents, hospitals, and local health jurisdictions.

Infant Protocol

Infants born to HBsAg-positive pregnant persons should receive HBIG and dose Number 1 of the hepatitis B vaccine within 12 hours of birth.  They should receive dose Number 2 at 1 – 2 months, and dose Number 3 at 6 months (not sooner than 24 weeks).  They should have post-vaccine serology done at 9 – 12 months (typically at the 12 month well child check) or 1-2 months after the vaccine series completion if the series is delayed.

Postvaccine serology includes both an HBsAg and an anti-HBs.  As of January 2018, it is recommended that infants who test negative for anti-HBs be revaccinated with a single dose of hepatitis B vaccine with repeat postvaccine serology done 1 – 2 months later.  If anti-HBs remain negative following single dose revaccination infants should receive 2 additional doses of hepatitis B vaccine to complete the second series, followed by postvaccine serology 1 – 2 months after the final dose.  No benefit has been shown for giving repeat doses of hepatitis B vaccine if the infant has not reached the protective level of anti-HBs after the administration of two full vaccine series.  Parents/ guardians should be counseled that the child is susceptible to hepatitis B infection and should receive HBIG if exposed to someone infected with hepatitis B.

Fewer than 5% of persons who receive 6 doses of properly administered hepatitis B vaccine fail to respond to the vaccine successfully.