Guidance

Hepatitis B dried blood spot (DBS) testing for children

Information and resources to support UKHSA's national DBS testing service to improve uptake of testing in primary care of infants born to mothers living with hepatitis B.

Applies to England

National hepatitis B dried blood spot service

The dried blood spot test or DBS for infants born to women living with hepatitis B is a national service that is offered free of charge by the UK Health Security Agency (UKHSA) to increase testing in the primary care setting of at-risk infants born to women living with hepatitis B.

Taking a DBS in general practice has been standard practice since 2014 to support the selective neonatal hepatitis B programme. DBS testing can be undertaken at any time between one year and 18 months of age in primary care, for example at an opportunistic healthcare attendance or at a routine appointment. Taking a DBS to check if a child has acquired hepatitis B virus (HBV) infection via vertical transmission is essential to ensure early referral into services for those children found to be at risk.

Dried blood spot testing

UKHSA offers a DBS test that has been validated in detecting hepatitis B surface antigen (HBsAg).

The DBS test uses an age-appropriate safety lancet to prick the heel of the child, allowing the healthcare professional to obtain several drops of blood, which are then applied to a filter paper. It is a simple, safe and easy way to test the child in a primary care setting. Standard infection control precautions prevent any risk of cross-infection, and allowing the blood to air dry onto the filter paper renders it safe for posting to the laboratory.

Programme documents

UKHSA has developed a range of resources to support healthcare professionals in practice.

The DBS training slideset includes information on how to prepare for and take a good quality bloodspot, demonstrates how to use the lancet, how to complete the form and what to do after taking the sample.

Download the slideset detailing How to take a good quality blood spot sample for healthcare professionals.

Watch a video demonstrating How to take a good quality blood spot sample, reproduced with kind permission from North East and North Cumbria ICS.

For further information, see:

Attachments

How to take a dried blood spot sample

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Hepatitis B vaccine for at-risk infants aide memoire

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If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@ukhsa.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Data reports in summary

Hepatitis B in England 2024

Additional resources

Testing of infants born to hepatitis B infected mothers: a 3-year review of the national DBS testing serviceHPR 11(5), 3 February 2017.

You can view resources from previous years on the National Archives, where you can also find the Rationale for not requiring high anti-HBs levels in infants born to HBsAg positive mothers.

Updates to this page

Published 30 September 2013
Last updated 11 June 2025 show all updates
  1. PHE references updated to UKHSA. Out-of-date resources replaced with current versions, such as the DBS training resources, the hepatitis B vaccine for at-risk infants aide memoire, and the instructions on how to take a dried blood spot sample.

  2. Added revised blood spot sample guide.

  3. Updated How to take a dried blood spot test video to include new detail on hexavalent infant vaccine.

  4. Updated 'Hepatitis B dried blood spot testing service' and 'Introducing parents to DBS testing' documents due to the introduction of the hexavalent vaccine.

  5. Added three-year review of the service (published in HPR 11(5), 3 February 2017).

  6. Addition of factsheet on PHE's free dried blood spot testing service

  7. First published.

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