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Immunization Program

CHILD Profile

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Background

  • The acute and chronic consequences of hepatitis B virus (HBV) infection are major health problems.
  • The Centers for Disease Control and Prevention (CDC) estimates 200,000-300,000 new HBV infections occur each year in the U.S.
  • Approximately 1-1.25 million persons have chronic HBV in the U.S. and are potentially infectious to others.
  • Many chronically infected persons are at risk of long-term effects, such as chronic liver disease and liver cancer. Each year, approximately 4,000-5,000 of these persons die from chronic liver disease.
  • At least 50% of persons who become infected have no symptoms and may not know they have it; and yet may be able to infect others. Unless someone has jaundice, the symptoms are flu-like (fatigue, abdominal pain, joint pain, and loss of appetite).
  • Of the approximately 4 million births in the U.S. each year, an estimated 19,000 occur to HBV-infected women. Unless these infants receive appropriate post-exposure prophylaxis, transmission of HBV from their mothers results in up to 90% of these infants becoming infected; of those infected, 90% will become chronic carriers. Up to 25% of the infants who become chronically infected will die from primary liver cancer or cirrhosis of the liver, usually as adults.
  • Immunization with hepatitis B vaccine is the most effective way to prevent HBV infection. Perinatal transmission of HBV can usually be prevented if HBsAg+ pregnant women are identified and their infants receive appropriate post-exposure prevention, which consists of hepatitis B immune globulin (HBIG) and hepatitis B vaccine, shortly after birth, followed by additional doses of vaccine at 1-2 months and 6 months of age for full protection. CDC recommends testing all pregnant women for HBV early in each pregnancy. Once a person is infected with HBV, hepatitis B vaccine will not help him/her.
  • In late 1989, the Washington State Department of Health (DOH) received grant funds from CDC to establish a perinatal hepatitis B prevention program. Such a program exists in all states and several U.S. territories.