So my baby will need two shots right after birth?” I was surprised and a bit skeptical. I was at the end of my pregnancy and was assured all had gone well so far. The vitamin K shot, to prevent bleeding in the fi rst days of life, made more sense — so I let them give it. The hepatitis B vaccine simply did not. Couldn’t it wait? Did my baby really need it? My labor and birth went well, my prenatal hepatitis B testing was negative, and my baby was born healthy. My nurse brought the topic up again. She was kind and gentle, but obviously hoped I’d change my mind. She offered me a chance to ask all my questions and explained why it’s important to give this first Hepatitis B vaccine in the hospital. Here’s what she shared, and why I agreed.

What is Hepatitis B and How Contagious is it?

Hepatitis B is a highly contagious viral infection that affects the liver, transmitted through blood and other body fluids. In its most intense stage, it may make the person feel ill, but most infected people don’t get sick or even know they have it, but they are contagious. While most people fully recover, some go on to develop a chronic form of the disease. People with chronic hepatitis B carry the virus in their bodies and can spread it to others without knowing it. This creates a great risk for those around them, especially infants. There’s no cure for hepatitis B and the disease can eventually lead to liver scarring (cirrhosis), liver cancer, liver failure, and even death. There are over 250 million people world-wide with chronic hepatitis B infections, and over 600,000 people who die from the disease each year.

Hepatitis B in the Newborn

Why is there such urgency to vaccinate our newborns so quickly? Part of the answer is this: Pregnant women can have chronic hepatitis B but not know it and pass it to their newborn during birth; or infected family members or caregivers can unknowingly or unintentionally expose the infant once home. In the United States alone, more than 25,000 babies are born each year to mothers with hepatitis B. Here are some other important reasons for this sense of urgency:

  • Hepatitis B is especially dangerous to infants. According to the Centers for Disease Control and Prevention, 40% of infants born to infected mothers will become infected and 90% will stay infected for life if preventative measures, including the vaccine, aren’t taken
  • Of these chronically infected infants, 25% will eventually die prematurely from liver disease or liver cancer later in life
  • Some good news: 90% of infections in exposed infants can be prevented with the hepatitis B vaccine, but timing is important

Hepatitis B infection is highly contagious for infants, impossible to cure, but easy to prevent if treatment, including the vaccine, is provided in time. Giving the hepatitis B vaccine to every newborn after birth acts as a safety net for infants who may be unknowingly exposed either during the birthing process or through contact with infected people at home, such as caregivers, friends, babysitters, or family members. This vaccine is endorsed by the American Academy of Pediatrics, the U.S. Centers for Disease Control and Prevention, and the World Health Organization. Since the vaccine’s introduction, there’s been a 90% decrease in acute hepatitis infections in the United States. The goal is to eliminate these infections completely and we’re getting close!

Hepatitis B Vaccine Safety

One final lingering concern for me was whether a newborn’s body can handle the vaccine at this age. And, of course, whether the vaccine was safe. Here are a few facts the nurse explained that helped boost my confidence in my decision:

  • All vaccines are extensively studied before they’re approved for use
  • The hepatitis B vaccine has almost 40 years of data and has been shown to be very safe. It’s been given to more than 120 million Americans, including newborns and infants
  • There’s no evidence of long-term health problems such as autism, auto-immune diseases, or asthma with this vaccine or others
  • The hepatitis B vaccine contains only non-infectious material that the immune system responds to while making the protective antibodies against the actual virus
  • A newborn’s immune system is well-equipped at the time of birth to handle the small challenge this vaccine provides. The amount of material given to the infant is much less of a challenge than normal bacterial and viral challenges they face every day from the foods they eat and organisms they are exposed to from their environment
  • Their body’s normal immune building response can cause parents some concern. The most common discomforts noted are soreness at the vaccination site and a low-grade fever
  • Severe reactions do occasionally occur but are very rare – about one in every 1.1 million doses given

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Sharon C. Hitchcock, DNP, RNC-MNN teaches nursing at the University of Arizona in Tucson, Arizona. She is passionate about reducing infant mortality and promoting infant safety. She serves on multiple state and national level teams dedicated to educating parents and reducing infant safety related deaths. 

Angelica Hibbs, FNP-C is a certified Family Nurse Practitioner in Tucson, Arizona, specializing in newborns and their families. Angelica is passionate about promoting healthy families and communities through evidence-based education and care.


Sharon Hitchcock DNP, RNC-MNN, teaches nursing at the University of Arizona in Tucson, Arizona. She is passionate about reducing infant mortality and promoting infant safety. She serves on multiple state and national level teams dedicated to educating parents and reducing infant safety-related deaths.

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