Hepatitis B Vaccination in Pregnancy in the United States

Hepatitis B remains a significant health issue worldwide, and contributes significantly to the incidence of cirrhosis and hepatocellular carcinoma. Widespread adoption of hepatitis B vaccination strategies has lead to significant declines in acute hepatitis B infections. Current recommendations for vaccination in the non-pregnant population include vaccinating all persons found to have risk-factors for disease acquisition. Hepatitis B virus is known to occur through vertical transmission or early childhood transmission, and strategies to decrease transmission include avoidance of exposure, avoidance of high-risk behaviors, universal screening of women during pregnancy, and active and passive immunization. It is currently recommended that all pregnant women undergo screening for hepatitis B virus at presentation for prenatal care. Those who engage in high-risk behavior should be re-screened at presentation for delivery. Studies have demonstrated the safety and efficacy of the hepatitis B vaccine in pregnancy, and its use is an important component in prevention of disease acquisition. Pregnant women in the United States who are found to be at risk for disease acquisition should be specifically targeted for vaccination.