High rates of hepatitis B vertical transmission in Kiribati: a warning sign for meeting 2030 WHO elimination targets in the Pacific Islands?

World Health Organization (WHO) goals for 2030 include a 90% reduction in new cases of hepatitis B (HBV) and a prevalence of less than 0.1% in children by 2030.1 The key to meeting these goals is the prevention of mother to child transmission of HBV (PMTCT). Hepatitis B immunoglobulin administration is impractical in most Pacific Island countries and territories (PICTs) due to its cost, storage requirements, and distribution challenges. Therefore, HBV birth dose vaccination (BDV) and anti-viral prophylaxis in HBV-positive pregnant women remain the two pillars of PMTCT.