TABLE 4-1 Hepatitis B Vaccine Schedules for Newborns, by Maternal HBsAg Status—ACIP Recommendations

Maternal HbsAg Status

Single-Antigen (Stand-alone) Vaccine

Single Antigen (Stand-alone) + Combination Vaccine

 

Dose

Age

Dose

Age

Positive

1a

Birth (up to 12 hours)

1a

Birth (up to 12 hours)

 

HBIGb

Birth (up to 12 hours)

HBIG

Birth (up to 12 hours)

 

2

1–2 months

2

2 months

 

3c

6 months

3

4 months

 

 

 

4c

6 months (Pediarix) or 12–15 months (Comvax)

Unknownd

1a

Birth (up to 12 hours)

1a

Birth (up to 12 hours)

 

2

1–2 months

2

2 months

 

3c

6 months

3

4 months

 

 

 

4c

6 months (Pediarix) or 12–15 months (Comvax)

Negative

1a,e

Birth (before discharge)

1a,e

Birth (before discharge)

 

2

1–2 months

2

2 months

 

3c

6–18 months

3

4 months

 

 

 

4c

6 months (Pediarix) or 12–15 months (Comvax)

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.



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