Infants are recommended to receive 4 doses of hepatitis B vaccine
Infants are recommended to receive 4 doses of hepatitis B vaccine:
- 1 dose of monovalent paediatric formulation hepatitis B vaccine at birth
- 3 doses of a paediatric hepatitis B–containing vaccine at 2, 4 and 6 months of age (usually provided as DTPa-hepB-IPV-Hib [diphtheria-tetanus-acellular pertussis, hepatitis B, inactivated poliovirus, Haemophilus influenzae type b]).
Infants can receive the dose scheduled at 2 months of age as early as 6 weeks of age. They should still receive their next scheduled doses at 4 months and 6 months of age.
Rationale for the birth dose
The rationale for the birth dose for all newborn infants is to prevent:1
- vertical transmission from a mother with chronic hepatitis B, recognising that there may be errors or delays in maternal testing, reporting, communication or appropriate response
- horizontal transmission to the infant in the first months of life from people with chronic hepatitis B who are household or other close contacts
Newborns should receive the birth dose as soon as they are medically stable, and preferably within 24 hours of birth, but the vaccine can be given within the first 7 days of life. Every effort should be made to give the vaccine before the baby is discharged from the obstetric hospital or delivery unit.
Alternative infant schedules
Although it is not routinely recommended in Australia, infants or toddlers who have received a 3-dose schedule of hepatitis B vaccine (often given overseas), with doses at birth, 1–2 months of age and ≥6 months of age, can also be considered fully vaccinated.
The final dose of the primary hepatitis B vaccine course in infants should preferably be administered at ≥24 weeks of age. However, if the final dose is given at <24 weeks but ≥16 weeks of age, it is not necessary to repeat the dose, provided the minimum intervals between doses have been met.
- diphtheria-tetanus-acellular pertussis vaccine
- inactivated poliomyelitis vaccine