Hepatitis B Vaccine Can Be Given During Pregnancy
Yes, the hepatitis B vaccine can and should be administered during pregnancy to women at risk for HBV infection, as it is safe and does not increase adverse pregnancy outcomes. 1
Who Should Receive HBV Vaccine During Pregnancy
The CDC specifically recommends hepatitis B vaccination for pregnant women who meet any of the following high-risk criteria 1, 2:
- More than one sex partner during the previous 6 months 1
- Evaluation or treatment for a sexually transmitted infection 1
- Recent or current injection-drug use 1
- HBsAg-positive sex partner 1
Any pregnant patient at high risk of contracting HBV or who requests the vaccine can be offered vaccination during pregnancy. 1
Safety Profile in Pregnancy
The evidence strongly supports the safety of hepatitis B vaccination during pregnancy:
- No association with increased adverse pregnancy outcomes including gestational hypertension, gestational diabetes, pre-eclampsia/eclampsia, cesarean delivery, pre-term delivery, low birthweight, or small for gestational age infants 3
- No congenital abnormalities observed in studies of first-trimester exposure 4
- Safe and highly immunogenic with passive transfer of antibodies to newborns 5
A large Vaccine Safety Datalink study examining over 650,000 pregnancies found no safety concerns among the 1,399 women who received HBV vaccine during pregnancy 3.
Important Clinical Context
While the vaccine is safe during pregnancy, it's crucial to understand its limitations:
- The vaccine does NOT prevent infant infection from maternal transmission 1
- The primary purpose of vaccinating pregnant women is to protect the mother from acquiring HBV infection during pregnancy, not to protect the infant 1
- Infants born to HBsAg-positive mothers require both HBIG and vaccine within 12 hours of birth for protection 2
Practical Implementation
All pregnant women should be tested for HBsAg during each pregnancy 1. For those who test negative but have risk factors:
- Initiate the standard 3-dose series (0,1, and 6 months) during pregnancy 1
- Do not delay vaccination while assessing risk factors 1
- Counsel on additional prevention methods beyond vaccination 1
Common Pitfall to Avoid
Do not confuse maternal vaccination with prevention of perinatal transmission. The vaccine given to pregnant women protects the mother from acquiring infection during pregnancy, but infants of HBsAg-positive mothers still require immediate postexposure prophylaxis at birth regardless of maternal vaccination status 2.