TABLE 4.

World Health Organization HBV elimination of mother-to-child transmission targets and progress of United States and Canada

Program indicator	Elimination target	United States	Canada
For countries with universal birth-dose vaccination
Coverage (%) of hepatitis B timely birth dose	Elimination: ≥90% Path to elimination: Gold ≥90% Silver ≥50%	81.5% infants received birth dose (2019–2020)28	—
Coverage (%) of 3-dose hepatitis B vaccine in infants	Elimination: ≥90% Path to elimination: Gold ≥90% Silver ≥90% Bronze ≥90%	92.1% coverage by 24 mo of age28	—
Coverage (%) of hepatitis B birth dose and HepB3 (3-dose HBV series) among infants at risk in all provinces or subnational areas	Elimination: ≥90% Path to elimination: NA	86% by 12 mo of age26
Coverage (%) of HBsAg testing among pregnant women	Elimination: ≥90% Path to elimination: Gold ≥30% Silver: NA	No National Surveillance Data 82% in claims assessment of 880,000 pregnancies38
Coverage (%) with antivirals among HBsAg-positive pregnant women eligible for prophylaxis or treatment	Elimination: ≥90% Path to elimination: NA	No National Surveillance Data 13% in study of 975 HBsAg+ pregnancies38
For countries without universal birth-dose coverage
Coverage (%) of 3-dose hepatitis B vaccine in infants	Elimination: ≥90% For path to elimination: Gold ≥90% Silver ≥90% Bronze ≥90%	—	Birth dose vaccination is not universal—only 3 P/T provide (representing 2.3% of Canadian population)(among 8 P/T in 2021), National Immunization Coverage Survey
Coverage (%) of HBsAg testing among pregnant women	Elimination: ≥90% Path to elimination: Gold ≥30% Silver: NA		No National Surveillance Data Estimated to be 80%–100% Reflex HBV DNA testing not routine on prenatal HBsAg positive39
Coverage (%) with antivirals among HBsAg-positive pregnant women eligible for prophylaxis or treatment	Elimination: ≥90% Path to elimination: NA		No National Surveillance Data All pregnant individuals with HBV DNA >200,000 IU/mL eligible for treatment

Abbreviations: NA, not applicable.