Hepatitis B birth dose vaccination coverage in Brazil (2016–2025): a temporal analysis based on national health data

Introduction:

Hepatitis B is a potentially severe viral infection, associated with the risk of progression to cirrhosis and hepatocellular carcinoma (WHO, 2024). Vaccination, available through the Brazilian Unified Health System (SUS) for all unvaccinated individuals, is the main preventive measure (Brazil, 2023). In children, the schedule includes four doses: at birth and at 2, 4, and 6 months of age, with the last one administered as part of the pentavalent vaccine. The birth dose, recommended within the first 24 hours of life and up to the 30th day, is critical to preventing vertical transmission (CDC, 2023; Brazil, 2022). The national vaccination coverage (VC) target for this dose is 95% (Brazil, 2023). VC is calculated by dividing doses administered by the number of live births, multiplied by 100 (Brazil, 2021). This study specifically assessed the coverage of the hepatitis B birth dose, without analyzing the completion of the full vaccination schedule.

Methods:
This descriptive study used secondary data from the National Health Data Network (RNDS) on annual coverage of the hepatitis B birth dose administered within 30 days of life, from 2016 to 2025. For 2025, data up to May were included. Coverage was compared to the 95% target and analyzed descriptively. Only the birth dose was evaluated, excluding subsequent doses of the schedule.

Results:
From 2016 to 2018, coverage ranged from 81.75% to 88.40%. In 2019, it declined to 78.57%, with sharper drops during the COVID-19 pandemic, reaching 65.77% in 2020 and 67.03% in 2021. Recovery was observed in 2022 (82.76%), reaching 84.54% in 2023, 94.90% in 2024, and 85.01% up to May 2025. No year consistently achieved the 95% target.

Conclusion:
Coverage of the hepatitis B birth dose in Brazil has fluctuated over the past decade, with a pandemic-related decline and a partial recovery thereafter. As the analysis was limited to the birth dose, data on the completion of the full series were not included. Strengthening neonatal vaccination strategies is essential to ensuring the prevention of vertical transmission.