Hepatitis B Immunization

The Canadian Liver Foundation supports universal neonatal vaccination against hepatitis B for all provinces in Canada, and urges the provincial governments to harmonize vaccination schedules across the country, so that children do not slip through the cracks as they move with their parents from province to province.  

Chronic hepatitis B is a disease that afflicts up to half a million people in Canada. The highest risk for acquiring chronic hepatitis B is in infancy and early childhood – an estimated 90 percent of newborns infected with hepatitis B will be infected for life. Infection at an older age carries a much lower risk for life-long infection (about 1%), and in most cases the patient recovers completely. Untreated chronic hepatitis B will cause premature death from liver failure and liver cancer in up to 20% of those who have the disease. Although the risk of these outcomes can be reduced with treatment in adulthood, treatment is expensive and may be required for life and is not as effective as prevention of hepatitis B in the first place.  

Canada provides universal vaccination against hepatitis B, but in most provinces the vaccine is provided to adolescents, rather than neonates, who have the highest risk of developing chronic disease.  No two provincial vaccination schedules are the same. Thus, a child born in a province that provides only adolescent vaccination that moves subsequently to a province that provides only neonatal vaccination will not be vaccinated all.  

Almost all countries that provide universal hepatitis B vaccination for their populations provide vaccine to newborns. The strategy is recommended by the World Health Organization, and in Canada is the strategy that is recommended by all the professional medical associations that deal with this issue, including the Canadian Pediatric Association, The Canadian Association of Medical Microbiology and Infectious Disease, and the Canadian Association for Study of the Liver. 

To download a PDF of this position statement, click here.