Hepatitis B vaccine (HepB) usually is given as a series of three injections:

1. shortly after birth
2. at 1–2 months of age
3. at 6–18 months of age

If the mother of a newborn carries the hepatitis B virus in her blood, her baby must receive the vaccine within 12 hours after birth, along with another shot — hepatitis B immune globulin (HBIG) — to immediately provide protection against the virus. If a newborn’s mother shows no evidence of the virus in her blood, the baby can receive the HepB vaccine within 24 hours after birth.

Why is the Vaccine Recommended?

The HepB injection usually creates long-term immunity. Infants who receive the HepB series should be protected from hepatitis B infection not only throughout their childhood but also into their adult years.

Eliminating the risk of infection also decreases risk for cirrhosis of the liver, chronic liver disease, and liver cancer. Young adults and adolescents also should receive the vaccine if they did not as infants.

Possible Risks

There is a very small chance of an allergic reaction with any vaccine. Serious problems associated with receiving the vaccine are rare. Problems that do occur tend to be minor, such as mild fever and soreness or redness at the injection site.

When to Delay or Avoid Immunization

As long as the mother does not have the virus in her blood, immunization will be delayed for babies who weigh less than 4 pounds, 7 ounces (2,000 grams) at birth. The first dose will be given at 1 month of age or when the baby is discharged from the hospital.

Routine Vaccination:

1. Minimum age: Birth
2. Administer monovalent HepB vaccine to all newborns within 48 hours of birth.
3. Monovalent HepB vaccine should be used for doses administered before age 6 weeks.
4. Administration of a total of 4 doses of HepB vaccine is permissible when a combination vaccine containing HepB is administered after the birth dose.
5. Infants who did not receive a dose at birth should receive 3 doses of a HepB containing vaccine starting as soon as feasible.
6. The ideal minimum interval between dose 1 and dose 2 is 4 weeks, and between dose 2 and 3 is 8 weeks. Ideally, the final (3rd or 4th) dose in the HepB vaccine series should be administered no earlier than age 24 weeks and at least 16 weeks after the first dose, whichever is later.
7. Hep B vaccine may also be given in any of the following schedules: Birth, 1, & 6 months; Birth, 6 and 14 weeks; 6, 10, and 14 weeks; Birth, 6, 10, and 14 weeks, etc. All schedules are protective.

Catch-up Vaccination:

1. Administer the 3-dose series to those not previously vaccinated.
2. In catch-up vaccination, use the 0, 1, and 6 months schedule.