Impact of Removing the Universal Hepatitis B Birth-Dose Vaccination in the US

What is the impact of replacing the universal hepatitis B virus (HBV) birth-dose vaccine recommendation with a targeted recommendation limited to infants of screened-positive or unscreened mothers?In this modeling study, the targeted recommendation resulted in more neonatal infections than universal vaccination under current maternal screening and birth-dose vaccination coverage. Preventing these additional infections would require screening approximately 100 000 more women.Targeted vaccination would likely increase neonatal infections even at current screening and vaccination levels; because vaccination coverage has historically declined when universal recommendations were withdrawn, the impact of such a change is likely to be greater.

Corresponding Author: Margaret L. Lind, PhD, School of Public Health, Boston University, 715 Albany St, Boston, MA 02118 (mllind@bu.edu).

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