May is Hepatitis Awareness Month and May 19th is Hepatitis Testing Day: During May, we need to shed light on the impact of viral hepatitis by raising awareness and encouraging testing and vaccination. For additional hepatitis resources refer to Hepatitis Awareness Month | CDC.
Birth Dose Hepatitis B: Prior to the pandemic, 84.3% of all babies born in Michigan were reported to have received hepatitis B (HepB) vaccine within 3 days of life. Recent rates show only 77.7% of babies are immunized with HepB vaccine. The Perinatal Hepatitis B Prevention Program (PHBPP) in collaboration with the Vital Events Registration Application (VERA) unit created a 3-minute Monthly Minute segment in March which can be found at www.michiganvera.org. This instructional video provided information on entering HepB vaccine and hepatitis B immune globulin (HBIG) administration or the reason why not given, along with documenting the pregnant person’s hepatitis B surface antigen (HBsAg) on the electronic birth certificate (EBC). For a quick summary, refer to Immunizations – Submitting Hepatitis B and Hepatitis B Immune Globulin Information in VERA (michiganvera.org).
PHBPP data: After review of the annual 2021 PHBPP data, there was a slight increase in the number of identified births to pregnant HBsAg positive persons in 2021 compared to 2020 data (2020 data showed a significant decrease from 2019). One hundred percent of the babies identified to the PHBPP received HepB vaccine and HBIG within 1 day of life (2% increase compared to 2020 data). Our birthing hospitals do an amazing job; 99% had HBIG and 3 HepB doses within 12 months (4% increase from 2020 – and far above the national average of 82%); 91% of babies had post vaccination serologic testing (4% increase – far above the 62% national average). Thank you to the birthing facility, provider office, and LHD staff for all of their hard work to protect MI babies from perinatal HepB transmission. For additional information go to www.michigan.gov/hepatitisB.
Perinatal/STI training: To better understand perinatal transmission of disease, Perinatal/STI training courses are now available for 2.5 nursing contact hours. Designed for OBGYN nurses at birthing facilities, but available to anyone who wants to learn more about Gonorrhea/Chlamydia, Adult Syphilis, Congenital Syphilis, Perinatal HepB, HepC, and HIV. To register for the training series, please refer to Instructions for Accessing the Perinatal/STI Training Series.
Resources: For perinatal HBV, HCV, HIV, and Syphilis reporting forms, case definitions, testing guidelines, and lab resource guides, go to: Perinatal (michigan.gov).
HepB vaccine: MDHHS provides HepB vaccine for all babies, for children through 18 years and since April 1, 2022, provides HepB vaccine for all adults. Based on CDC’s Universal Hepatitis B Vaccination in Adults Aged 19–59 Years: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2022 | MMWR (cdc.gov), MDHHS has removed the risk factor for screening and disclosure for all adults aged 19 – 59 years and encourages providers to offer hepB vaccine to all adults aged 60 years and older with or without risk factors. Refer to the MI VFC Provider Manual for more information about MI’s Universal HepB Program, Vaccines for Children (VFC) Program, High-Risk Hepatitis A and B Program and MI’s Adult Vaccine Program (AVP).
HepB testing: HepB testing prior to 2008, was a risk-based screening recommendation. On March 10, 2023, CDC published Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations — United States, 2023 | MMWR, which recommends a universal testing approach for anyone 18 years of age and older, at least once in their lifetime. A 3-part testing process for hepatitis B surface antigen (HBsAg), hepatitis B surface anti-body (anti-HBs) and hepatitis B total core anti-body (Total anti-HBc). These recommendations also include a reminder to test all pregnant persons during each pregnancy for HBsAg regardless of vaccination status, history, or testing. Additionally, CDC recommends ongoing risk assessment for exposure with periodic testing and to test anyone who requests HBV testing.
If you have additional questions, contact Pat Fineis at 517-242-8319.