^aRecombivax HB or Engerix-B should be used for the birth dose. Comvax and Pediarix cannot be administered at birth or before the age of 6 weeks.

^bHBIG (0.5 mL) administered intramuscularly in a separate site from vaccine.

^cFinal dose in vaccine series should not be administered before the age of 24 weeks.

^dMothers should have blood drawn and tested for HBsAg as soon as possible after admission for delivery; if mother is found to be HbsAg-positive, infant should receive HBIG as soon as possible but no later than the age of 7 days.

^eOn a case-by-case basis and only in rare circumstances, first dose may be delayed until after hospital discharge for an infant who weighs 2,000 g and whose mother is HbsAg-negative, but only if physician’s order to withhold birth dose and copy of mother’s original HBsAg-negative laboratory report are documented in infant’s medical record. Abbreviations: HBsAg, hepatitis B surface antigen; ACIP, Advisory Committee on Immunization Practices; HBIG, hepatitis B immune globulin.

SOURCE: Mast et al., 2005.