Introduction of Hepatitis-B Birth Dose in the Routine Immunization Schedule: Recommendation of the Tanzania Immunization Technical Advisory Group

Background: In 2022, the World Health Organization (WHO) estimated that hepatitis B virus (HBV) infection associated complications caused around 1.1millions deaths worldwide, translating into 14 deaths per 100,000 population. Vaccination for HBV is the most cost-effective intervention against HBV infection.  WHO recommends all infants to receive the hepatitis B birth-dose (HepB-BD) vaccine against HBV infection as early as possible (preferably within 24 hours after birth) and a complete childhood vaccine series for maximum protection against the infection.  However, Tanzania is yet to introduce the HepB-BD vaccine which exposes newborns to the risk of mother-to-child transmission and early childhood infections. Methods: The Tanzania Immunization Technical Advisory Group (TITAG) held its meeting in May 2023 to review available evidence regarding safety, efficacy, cost effectiveness, and the programmatic implications of introducing the HepB-BD vaccine in the routine childhood vaccination schedule. Results and recommendation: High-quality evidence available has clearly demonstrated that the HBV monovalent HepB-BD vaccine has acceptable safety profile, highly efficacious in prevention of Mother-to-Child Transmission (MTCT) and early childhood HBV infections, and highly cost-effective.  TITAG recommended that the universal HepB-BD vaccine be introduced in routine vaccination in Tanzania, with maximum leverage on the existing immunization structures, coupled with routine surveillance for safety and effectiveness of the vaccines.