BOX 4-1

Summary of ACIP Hepatitis B Vaccination Recommendations

Vaccination of infants


At birth

  • Infants born to mothers who are HbsAg-positive should receive hepatitis B vaccine and HBIG within 12 hours of birth.

  • Infants born to mothers whose HBsAg status is unknown should receive hepatitis B vaccine within 12 hours of birth. The mother should have blood drawn as soon as possible to determine her HBsAg status; if she is HbsAg-positive, the infant should receive HBIG as soon as possible (no later than the age of 1 week).

  • Full-term infants who are medically stable, weigh over 2,000 g, and are born to HBsAg-negative mothers should receive single-antigen hepatitis B vaccine before hospital discharge.

  • Preterm infants weighing less than 2,000 g and born to HbsAg-negative mothers should receive the first dose of vaccine 1 month after birth or at hospital discharge.

After the birth dose

  • All infants should complete the hepatitis B vaccine series with either single-antigen vaccine or combination vaccine according to a recommended vaccination schedule.

  • Infants born to HBsAg-positive mothers should be tested for HBsAg and antibody to HBsAg after completion of the hepatitis B vaccine series at the age of 9–18 months.

Vaccination of children and adolescents

  • All unvaccinated children and adolescents less than 19 years old should receive the hepatitis B vaccine series.

from the 2007 National Immunization Survey, which were collected after implementation of the 2005 ACIP recommendation, CDC estimates that the national newborn hepatitis B vaccine coverage was 46% at the age of 1 day (CDC, 2009b).

As noted above, despite the ACIP recommendation to vaccinate all newborns, about 1,000 newborns each year become chronically infected with HBV. Even with the ACIP recommendation, birth doses of the hepati-



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