Peer-reviewed article
Progress toward elimination mother-to-child transmission of HBV in Shandong Province, China: Coverage trend in hepatitis B vaccination and HBIG administration, 2017-2024.
Xin Meng, Weiling Zhang, Bingyu Yan, Yi Feng, Jingjing Lu et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tracked progress in preventing mother-to-child transmission of hepatitis B in Shandong Province, China from 2017 to 2024. Vaccination coverage and protective treatment (HBIG) improved significantly over the period, particularly for high-risk newborns. However, very low birthweight infants born to hepatitis B-positive mothers still have lower coverage rates and need better targeted interventions.
Key points
- Maternal hepatitis B surface antigen (HBsAg) prevalence decreased from 2.85% to 2.10% between 2017 and 2024
- Timely hepatitis B vaccine birth dose coverage reached 94.42% in preterm neonates with HBsAg+ mothers and 86.26% in very low birthweight neonates
- HBIG (hepatitis B immune globulin) administration coverage increased significantly, achieving high levels (93.96%) by 2024 except in the lowest birthweight group
- Very low birthweight neonates (under 2000g) born to HBsAg+ mothers showed the lowest fourth-dose vaccination coverage (72.93%), though this improved over time
- Enhanced health education for parents and additional training for healthcare providers are needed to improve coverage in remaining high-risk groups
Limitations
The study does not evaluate the effectiveness of the interventions in actually preventing infant infections or report clinical outcomes such as infection rates. It only measures vaccination and treatment coverage rates, not whether protected newborns remained infection-free.
Abstract
To evaluate progress toward MTCT elimination of HBV, we analyzed 8-y trends in hepatitis B vaccine (HepB) and hepatitis B immune globulin (HBIG) administration coverage rates in Shandong province, focusing on high-risk populations. Data were collected from a provincial system, Shandong Vaccination Information System. Information of maternal HBsAg+ neonates born in 2017-2024 were extracted. Administration coverage in four groups (A: general newborn, B: maternal HBsAg+ neonates, C: preterm neonates with HBsAg+ mother, and D: birthweight <2000 g (LBW2000) neonates with HBsAg+ mother) were calculated. Joinpoint models were used to analyze changing trends over time, calculating annual percentage change (APC). From 2017 to 2024, the maternal HBsAg+ rate dropped from 2.85% to 2.10% (APC = -0.10, P < .001), with an accelerating rate of decrease after 2021. Timely HepB birth dose (HepB-BD) vaccination coverage rose annually, reaching 94.42% in Group C (APC = 4.92, P = .001) and 86.26% in Group D (APC = 5.86, P < .001). Timely HBIG administration coverage increased significantly before 2021, achieving high levels by 2024 except in Group D (93.96%). The 4th dose of HepB (HepB4) vaccination coverage in Group D showed a nonsignificant increase (56.51% to 72.93%), with median administration time decreasing from 13.24 to 8.59 months. MTCT Elimination of HBV has improved substantially. However, LBW2000 neonates born to HBsAg+ mothers require focused attention, particularly regarding administration coverage of timely HBIG and HepB4. Enhanced health education for parents and additional clinical training for healthcare providers are needed to improve intervention coverage.