Hepatitis B vaccination coverage and risk factors associated with incomplete vaccination of children born to hepatitis B surface antigen-positive mothers, Denmark, 2006 to 2010

Abstract

In Denmark, universal screening of pregnant women for hepatitis B has been in place since November 2005, with the first two years as a trial period with enhanced surveillance. It is unknown what the change to universal screening without enhanced surveillance has meant for vaccination coverage among children born to hepatitis B surface antigen (HBsAg)-positive mothers and what risk factors exist for incomplete vaccination. This retrospective cohort study included 699 children of mothers positive for HBsAg. Information on vaccination and risk factors was collected from central registers. In total, 93% (651/699) of the children were vaccinated within 48 hours of birth, with considerable variation between birthplaces. Only 64% (306/475) of the children had received all four vaccinations through their general practitioner (GP) at the age of two years, and 10% (47/475) of the children had received no hepatitis B vaccinations at all. Enhanced surveillance was correlated positively with coverage of birth vaccination but not with coverage at the GP. No or few prenatal examinations were a risk factor for incomplete vaccination at the GP. Maternity wards and GPs are encouraged to revise their vaccination procedures and routines for pregnant women, mothers with chronic HBV infection and their children.

Maternal knowledge of the risk of vertical transmission and offspring acquisition of hepatitis B

“…Other studies have demonstrated variable rates of prophylaxis implementation. Data from the United Kingdom showed that 99.4% of infants born to HBsAg positive women received the birth dose of the HBV vaccine [ 16 ], however a similar retrospective analysis in Denmark showed that only 93% of children born to HBsAg positive women were vaccinated within 48 h of birth [ 17 ].…”

“…Thus, the child’s future medical providers may not have the information they need to appropriately manage these children. In particular, completing the full HBV vaccine series is challenging [ 16 , 17 , 21 ], yet crucial to prevent acquisition of HBV by the child.…”

Immune Tolerant Chronic Hepatitis B: The Unrecognized Risks

“…A lack of public knowledge and ongoing stigma surrounding HBV will pose barriers in some communities, regardless of national wealth [63,116,117]. Many of these challenges are not applicable in developed Western nations, yet effective delivery of both targeted and universal vaccination programmes still appears to remain suboptimal [104,118,119]. Further large-scale investment will be needed globally to eliminate HBV as a major public health problem [120].…”

Global Cancer in Women: Cancer Control Priorities

“…In 6 European countries (Denmark, Finland, Iceland, Norway, Sweden, and the United Kingdom), where the prevalence of chronic HBV infection is <1% (102), universal HBV vaccination is considered unnecessary, and only high-risk groups and infants born to pregnant women who test positive for HBV infection receive vaccination (106). In those countries, however, many eligible infants (born to mothers with HBV) and infants born to mothers with unknown HBV status (especially among immigrants) may not receive some or any doses of HBV vaccine (106,107).…”