Babies are at risk of catching hepatitis B from their mothers and from contact with others who are infected. Giving the first dose of the vaccine after birth is highly effective at preventing the disease in newborns and is recommended for all babies.
Hepatitis B is a virus that infects the liver and can cause mild or severe liver disease, liver cancer, and death. The disease process can last for years. Like all viral infections, there is no medication that can cure the virus. The virus is transmitted through direct contact with body fluids, including blood, sexual contact, and saliva. It is no longer transmitted through blood transfusions since blood donors are tested for the virus. It is still commonly transmitted through sharing needles in drug abuse, accidental exposures to needles and blood, and through sexual contact.
Hepatitis B can also be transmitted to babies during delivery; for this reason, mothers are tested for the virus. If the mother is positive, two medications are given to the baby, both of which have been shown to help prevent transmission. The first is the hepatitis B vaccine, and the second is hepatitis B immune globulin (HBIG). The hepatitis B vaccine is also recommended for all babies in the hospital, even those whose mom’s do not have it and those who are immune to it.
Hepatitis B vaccine is also recommended after delivery in all babies, including those whose mothers do not have hepatitis B and those who are proven to be immune to the virus through vaccination. The rationale for this is that not all mothers are tested for it with routine prenatal care, sometimes mistakes are made or labs are not checked, it is given during infancy anyway as part of the routine vaccine schedule, so starting it right after delivery will catch any babies who might have fallen through the cracks so to speak.
In most nurseries, the baby will get its first hepatitis B vaccine. This vaccine is part of the normal childhood immunization schedule; everyone needs 3 of these shots. Babies are at risk for getting hepatitis B only if the mother has it, and all mothers are tested now for it as part of routine prenatal care. Hepatitis B is also transmitted sexually and through IV drug abuse, which of course are not risks in newborns. (There is also a very slight theoretical risk of transmission through close household contact with someone with Hepatitis B). Some parents choose not to give this vaccine in the hospital if the mom does not have hepatitis B since the baby is not at risk, and others choose to go ahead and give it anyway.
Bottom line: I think it is safe and effective and fine to give to newborns; I also think that it is acceptable to wait on this vaccine if the baby is not at risk for getting hepatitis B from its mother.
