Perinatal Hepatitis B

This program provides support, education, and reminders to providers to ensure that all infants born to HBsAG+ mothers follow the CDC protocol to prevent contracting hepatitis B during delivery.

Hepatitis B Testing for Pregnant Women

All pregnant women should be tested for hepatitis B with every pregnancy.

Screening Pregnant Women for Hepatitis B Virus (HBV) Infection: Ordering Prenatal Hepatitis B Surface Antigen (HBsAg) Tests from Major Commercial Laboratories (PDF).

Under state law, providers must report HBsAG+ women to the Snohomish Health District within three working days as a notifiable condition.

To Report

  • Monday through Friday from 8 a.m. to 5 p.m. 
  • Phone 425-339-5235
  • Fax 425-338-8706
  • Non-urgent after hours, leave a message at 425-339-5235

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

Infant Protocol

These infants should receive HBIG and dose Number 1 of hepatitis B vaccine within 12 hours of birth. They should receive dose Number 2 at 1 to 2 months, dose Number 3 at 6 months (not sooner than 24 weeks), and should have post-vaccine serology at 9 to 12 months (typically at the 12 month well child check). This is an updated CDC protocol as of October 9, 2015.

Postvaccine serology is an HBsAG and an anti-HBs. If the HBsAg is negative and the anti-HBs is positive, the child is immune due to vaccination. 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 and receive postvaccine serology 1 to 2 months later. Infants whose anti-HBs remain negative following single dose revaccination should receive 2 additional doses of hepatitis B vaccine to complete the second series, followed by postvaccine serology 1 to 2 months after the final dose. If they still show no protection, then they are termed a "non-responder" and are susceptible to hepatitis B infection. Parents/guardians should be counseled about the child receiving 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.