Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

HBV Vaccination Coverage in Foreign-Born Women

Clin Infect Dis; ePub 2018 Jun 1; Kilmer, et al

Foreign-born women of reproductive age living in the US have lower hepatitis-B virus (HBV) vaccination and screening coverage than their US-born counterparts and screening for HBV is underutilized, a recent report suggests. Researchers pooled data from the National Health Interview Survey 2013-2015 to estimate prevalence of lifetime history of HBV vaccination and screening which was self-reported by women aged 18 to 44 years who were born in the US or elsewhere. They found:

  • Among women of reproductive age (n=24,216), the reported HBV vaccination was 33% lower for foreign-born (27.3%) than US-born (40.9%) women.
  • Vaccination coverage was low for women born in Mexico and other parts of Central America.
  • Factors associated with vaccination in both groups included education, income, and health insurance coverage.
  • Screening was reported by 28.5% of foreign-born vs 31.9% of US-born women.


Kilmer GA, Barker LK, Ly KN, Jiles RB. Hepatitis B vaccination and screening among foreign-born women of reproductive age in the United States: 2013-2015. [Published online ahead of print June 1, 2018]. Clin Infect Dis. doi:10.1093/cid/ciy479.


We have been vaccinating adolescents for hepatitis B since the late 1990s. Many of these women are now in their prime reproductive years. We should not assume that women born in another country have received the hepatitis-B vaccination, nor should we assume it for woman born in this country. The reason this is of great importance for women of reproductive age is because children that acquire hepatitis B at birth have close to a 90% chance of becoming a chronic carrier if there is no intervention. Children born to mothers who are hepatitis B surface antigen positive should receive HBIG and the hepatitis B vaccine within 24 hours to decrease transmission. It was interesting in this study that there was a low population of woman from Asia, where hepatitis B is much more endemic. — John Russell, MD

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