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CHANDIGARH — A startling breakdown in Punjab’s neonatal healthcare system has left thousands of infants vulnerable to chronic liver disease. Official data from the National Viral Hepatitis Control Programme (NVHCP) reveals that during the first half of the 2025-26 fiscal year, only 28.8% of newborns born to Hepatitis B-positive mothers received the life-saving Hepatitis B Immunoglobulin (HBIG) within the critical 24-hour window.
The figures, spanning April to December 2025, show that out of 995 identified high-risk infants, only 287 received the dual protection of the vaccine and the immunoglobulin. This gap persists despite strict national mandates, prompting state health authorities to issue urgent directives in early 2026 to bridge a divide that experts warn could create a new generation of chronic virus carriers.
A Failure of the ‘Safety Net’
Hepatitis B (HBV) is a viral infection that attacks the liver and can be transmitted from an infected mother to her child during childbirth. For these “high-risk” infants, the standard birth dose of the Hepatitis B vaccine is not enough. To effectively block transmission, they require a “dual shield”: the monovalent vaccine plus HBIG (100 IU) administered intramuscularly.
According to NVHCP guidelines, this combination must be administered within 12 to 24 hours of birth. When given correctly, it slashes the risk of perinatal infection by over 90%. Without it, an infant born to a highly infectious mother faces a 90% chance of developing a chronic infection—a stark contrast to adults, who clear the virus in 90% of cases.
“The Hepatitis B vaccine is one of the most important steps we can take to protect babies in their first 24 hours of life,” says Dr. James Campbell, a pediatric infectious disease expert. “Vaccinating newborns provides a critical safety net. For those at high risk, HBIG is the essential reinforcement that prevents a lifetime of health complications.”
The Data Gap: Private Sector Silence
The statewide average of 29% masks even deeper regional disparities. Some districts in Punjab reported alarmingly low coverage rates:
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Pathankot: 2.9% (Only 1 out of 34 high-risk newborns protected)
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Fatehgarh Sahib: 7.1% (3 out of 42 protected)
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Muktsar: 8.1% (5 out of 62 protected)
A significant factor behind these dismal numbers is the “black hole” of private sector reporting. While nearly 50% of deliveries in Punjab occur in private medical facilities, official records showed zero HBsAg-positive births reported from the private sector during this period. Health officials suggest this is not due to a lack of cases, but rather a systemic failure in coordination and data sharing between public and private institutions.
Comparison of HBIG Administration Rates (April – Dec 2025)
| District | High-Risk Births Identified | HBIG Administered | Coverage % |
| Pathankot | 34 | 1 | 2.9% |
| Fatehgarh Sahib | 42 | 3 | 7.1% |
| Muktsar | 62 | 5 | 8.1% |
| Statewide Total | 995 | 287 | 28.8% |
The Human Cost of Delayed Protection
For an infant, contracting Hepatitis B is often a “silent” sentence. Chronic HBV progresses to liver cirrhosis or primary liver cancer in approximately 25% of cases later in life. In Punjab, where the general prevalence of chronic HBV is roughly 1.4%, the failure to protect high-risk newborns unnecessarily amplifies the future burden on the state’s healthcare infrastructure.
State health officials have flagged “backlog clearance” and “inaccurate reporting” as major hurdles. At a recent National Programme Coordination Committee (NPCC) meeting in New Delhi, the Ministry of Health escalated the issue, demanding that Punjab address the logistical bottlenecks—such as HBIG stockouts and the lack of trained personnel—that prevent timely administration.
Systemic Hurdles and Government Action
The barriers to 100% coverage are multifaceted:
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Screening Gaps: Inconsistent antenatal screening means many HBsAg-positive mothers are not identified before they go into labor.
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Logistical Strain: HBIG is expensive and requires a cold chain for storage, which can lead to stockouts in rural or overburdened centers.
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Reporting Lapses: The lack of a unified digital tracking system allows high-risk cases to fall through the cracks during the transition from the delivery room to the immunization ward.
In response, Punjab’s Civil Surgeons received “stern instructions” in March 2026. New mandates require the labeling of all high-risk cases during pregnancy, mapping every high-risk delivery to a specific facility with guaranteed HBIG stock, and enforcing a strict reporting deadline of the 10th of every month.
What This Means for Expectant Parents
For families in Punjab, these findings underscore the need for proactive engagement with healthcare providers.
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Request Screening: Every pregnant woman should confirm they have been screened for HBsAg during their first or second trimester.
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Verify Readiness: If a mother tests positive, she should ensure her chosen delivery facility—whether public or private—has HBIG in stock well before her due date.
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Check Records: After birth, parents should verify that both the vaccine and the immunoglobulin were recorded in the child’s immunization card.
A Balanced Outlook
While the current data is sobering, it is important to note that Punjab has seen significant success in other areas of liver health, including over 60,000 cures for Hepatitis C. Furthermore, national birth dose vaccination rates remain relatively high (between 75% and 94%). The challenge lies specifically in the targeted intervention for the most vulnerable infants.
Public health experts argue that while HBIG is logistically demanding, achieving 100% coverage is feasible. It requires treating Hepatitis B protection not just as a routine jab, but as an emergency medical intervention.
References
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Economic Times Health. “Only 29% high-risk newborns in Punjab get Hepatitis B protection.” March 3, 2026.
Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.
