Hepatitis B seroprevalence among children aged 0.6–14 years in Jiangsu, China, in 2023–2025

China has implemented universal hepatitis B vaccination in all neonates since 2002 and has enhanced prophylaxis against mother-to-child transmission of hepatitis B virus (HBV) by providing charge-free hepatitis B immunoglobulin in infants of HBV-infected mothers since 2011 and by recommending routine antiviral prophylaxis in HBV-infected mothers with high viral loads since 2020. We aimed to survey the seroprevalence of hepatitis B surface antigen (HBsAg) in children born from 2010 to 2024 in Jiangsu Province, based on convenience sampling in children who visited hospitals. We tested hepatitis B markers in 20,317 children aged 7.9 ± 4.1 years, with 11477 boys and 8840 girls, from 8 cities across Jiangsu during February 2023 to December 2025. Of them, 14 (0.069%, 95% CI: 0.038–0.116) were HBsAg positive. The positive rates of HBsAg in 0.5–<3, 3–<6, 6–<9, 9–<12, and 12–<15 years groups were 0% (0/2520), 0% (0/3858), 0.024% (1/4243), 0.136% (6/4401), and 0.132% (7/5295), respectively (P = .01489). The overall positive rate of antibody against HBsAg was 68.11% (12046/17686), with a decreasing trend over the ages (from 96.17% in 0.5–<3 year children to 48.41% in 12–<15 year children). In HBsAg-negative children, the positive rate of antibody against hepatitis B core antigen was 7.68% (1383/18007), increasing from 4.23% in 0.5–<3 year children to 7.84% in 12–<15 year children (Z = 5.0398, P < .0001). The present study showed that HBsAg prevalence among children in Jiangsu has substantially declined since the implementation of enhanced prevention of HBV perinatal infection.