Timely hepatitis B birth dose highly effective in preventing mother-to-child transmission in Ethiopia
- A cross-sectional study in Ethiopia found that timely hepatitis B birth dose vaccination was highly effective in preventing mother-to-child transmission.
- Overall mother-to-child transmission risk was 5.2% (95% CI 3.4, 7.8) in the study population.
- Transmission was 0% (0/39, 95% CI 0-9.0) among infants receiving the hepatitis B birth dose alone, compared with 15.3% (20/131, 95% CI 10.1-22.4) in those without immunoprophylaxis at birth (p = 0.009).
- No transmission occurred among infants receiving both the birth dose and hepatitis B immunoglobulin (0/217, 95% CI 0-1.7).
The publication
A cross-sectional study in Ethiopia found that timely hepatitis B birth dose vaccination was highly effective in preventing mother-to-child transmission. No transmission occurred among 39 infants receiving the birth dose alone or 217 receiving it with immunoglobulin, compared with 15.3% in those without immunoprophylaxis at birth.
Who the findings apply to
The study included 387 children born to mothers who tested positive for hepatitis B surface antigen (HBsAg) during pregnancy and negative for HIV.
Infants were assessed for hepatitis B virus transmission at 6 to 12 months post-partum, with a median testing age of 10 months.
All participants had completed the routine three-dose hepatitis B vaccination series (HepB3).
Effectiveness was stratified by maternal risk profiles, including hepatitis B virus DNA levels and hepatitis B e-antigen (HBeAg) status.
Why this matters
Mother-to-child transmission is a major driver of new hepatitis B infections in Africa, where data on birth dose effectiveness have been limited and conflicting. This study provides direct evidence that administering the first dose at birth, rather than waiting for the routine 6-week series, is highly effective in preventing transmission. The results support prioritizing scale-up of timely birth dose vaccination to protect infants born to hepatitis B-positive mothers.
What the study found
Overall mother-to-child transmission risk was 5.2% (95% CI 3.4, 7.8) in the study population.
Transmission was 0% (0/39, 95% CI 0-9.0) among infants receiving the hepatitis B birth dose alone, compared with 15.3% (20/131, 95% CI 10.1-22.4) in those without immunoprophylaxis at birth (p = 0.009).
No transmission occurred among infants receiving both the birth dose and hepatitis B immunoglobulin (0/217, 95% CI 0-1.7).
Among infants without immunoprophylaxis at birth, maternal viral load greater than 200,000 IU/ml (AOR 16.6, 95% CI 4.82, 57.19) and HBeAg positivity (AOR 4.21, 95% CI 1.08, 16.44) were associated with increased transmission risk.
What the result does not establish
The study was a multi-centre cross-sectional observational design, which limits the ability to establish causality compared to randomized trials.
The sample size for the birth dose alone group was small (n=39), resulting in a wide confidence interval (0-9.0%) for the zero transmission rate.
The study was conducted in Ethiopia, so generalizability to other regions with different vaccination schedules or viral strains may be limited.
The analysis relied on routine vaccination completion, and the specific timing of the birth dose relative to delivery was not detailed in the abstract.
Authors’ conclusion
“In Ethiopia, the current vaccination series starting at 6 weeks is insufficient to prevent HBV MTCT. Timely HepB-BD is highly effective in reducing HBV MTCT and should be prioritised for scale-up in Africa.”
Study and sources
Effectiveness of timely hepatitis B birth dose vaccination to prevent mother-to-child transmission in Ethiopia
Real-world / observational study · Clinical infectious diseases · 2026-09-24
Sources and limitations
- PubMed record PMID 42781776 (PubMed / NLM · 2026-09-26)
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