I have some Asian and African children and teens in my practice who were born abroad. Should I test them all for hepatitis B, or just make sure they are all vaccinated?

All foreign-born people (including immigrants, refugees, asylum seekers, and internationally adopted children) born in Asia, the Pacific Islands, Africa, and other regions with high or intermediate endemicity of HBV infection should be tested for HBsAg, regardless of vaccination status. Initiating HepB vaccination of immigrant children should not be delayed while awaiting HBsAg test results: you may draw blood for testing then administer the first dose of vaccine at the same visit. All people found to be HBsAg-positive should have ongoing medical management by a physician knowledgeable about hepatitis B and its complications.