Pediatricians

6 Actions to Complete

1) Ask about maternal history regarding Hepatitis B status

2) Contact our program to notify us that an infant exposed to Hepatitis B at birth is under your care

3) Check infant's birth record to ensure post exposure prophylaxis (PEP) was administered

• Consists of both Hepatitis B vaccine and Hepatitis B Immune Globulin (HBIG)
• Both should have been administered within 12 hours of birth
• Should have been administered in separate limbs.

4) Review and educate parents on Hepatitis B vaccine schedule

5) Administer and document Hepatitis B vaccines given according to ACIP recommended schedule

6) Complete Post-Vaccination Serology Testing (PVST) when child is 9-12 months of age

• PVST should be ordered when the following criteria are met:
  • Child has completed 3-4 dose Hepatitis B vaccine series
    
  • Child is at least 9 months old and last dose of Hepatitis B vaccine was administered 1 to 2 months ago
• PVST includes both Hepatitis B surface antigen (HBsAg) and Hepatitis B surface antibody (quantitative)
• Interpreting results - review CDC's table below

Please report the PVST results to us as soon as they are available by sending the laboratory reports via secure email or fax:

• Secure email: PHS-PerinatalHepB.HHSA@sdcounty.ca.gov
• Fax: 619-692-5677

Important to Note

PVST can be collected too early.

If Post-Vaccination Serology Testing (PVST) is collected prior to the child being 9 months of age, or before a month has passed since the last dose was administered, it may yield inaccurate test results. Please see examples below.

• Hepatitis B surface antigen may be falsely positive if the vaccine was recently given, and the lab was collected within one month of the dose being administered.
• Hepatitis B surface antigen can also result as negative if collected too early, as a result of the infant receiving HBIG.
• Hepatitis B surface antibody may be falsely positive when collected too early as a result of the antibodies that are passed from the mother to baby, along with the administration of HBIG.

PVST can still be collected even if a significant amount of time has passed, and the child is older than 12 months of age.

However, it is important to note that antibody levels significantly decline within the first year after vaccination, which is why it is important to complete the PVST as soon as the infant is eligible. If more than 6 months have passed since the last dose was given and PVST hasn’t been completed, you may consider providing the infant with an additional dose of Hepatitis B vaccine and then completing the PVST 1-2 months after the vaccine has been administered. 

Resources and Additional Information

We really appreciate your assistance and continued cooperation to help make the perinatal Hepatitis B prevention program a success in San Diego County.

Please see some additional resources below regarding pediatrician guidance.