4 Things Pharmacists Should Know About Hepatitis B Vaccination for Infants

Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). The virus is transmitted through blood, semen, or other body fluids from an infected person. HBV can also be transferred from an infected mother to her baby at birth. In fact, approximately 90% of infected infants become chronically infected, which can lead to serious health complications and even death.¹ Check out 4 things you should know about hepatitis B vaccination for infants.

• The first dose should be administered within 24 hours of birth.

The CDC and the American Academy of Pediatrics updated their recommendations that the first dose of the hepatitis B vaccine (0.5 ml) be administered to all newborns, weighing 2 kg (4.4 pounds) or more at birth, within 24 hours of birth or at hospital discharge, whichever comes first.² Preterm infants weighing less than 2 kg born to hepatitis B negative mothers should receive the first vaccine dose 1 month after birth or at hospital discharge.²

• Newborns of hepatitis B positive mothers should be administered 2 vaccines.

Newborns of hepatitis B positive mothers should be administered both the hepatitis B immune globulin (HBIG, 0.5 ml) and hepatitis B vaccine (0.5 ml) at separate injection sites within 12 hours of birth.² The pediatrician should be notified regarding the importance of on-time vaccination as well as postvaccination testing of the infant.²

• The hepatitis B vaccine is a 3-dose series.

The second dose should be administered at age 1 or 2 months.³ The monovalent hepatitis B vaccine should be used for doses administered before 6 weeks of age. The third dose should be administered at least 8 weeks after the second dose and at least 16 weeks after the first dose. The final (3^rd or 4^th dose) dose in the series should be administered no earlier than 24 weeks of age. Infants who did not receive a birth dose of the vaccine should receive 3 doses of a hepatitis B containing vaccine on a schedule of 0, 1-2 months, and 6 months. Administration of a total of 4 doses of the hepatitis B vaccine is permitted when a combination vaccine containing HepB is administered after the birth dose.³

• The hepatitis B vaccine is safe and effective.

The hepatitis B vaccine is safe and effective at preventing the disease. Patients may have pain at the injection site or fever. Most infants do not experience any adverse effects. After receiving the 3 dose series, the vaccine is more than 90% effective at preventing the HBV infection.⁴ Since the vaccine became available in 1982, more than 100 million individuals have received the immunization in the United States with no serious side effects reported.⁴

References

• Viral hepatitis. CDC website. https://www.cdc.gov/hepatitis/hbv/index.htm. Accessed September 13, 2017.
• Guidance for developing admission orders in labor & delivery and newborn units to prevent hepatitis B virus transmission. Immunization Action Coalition website. http://www.immunize.org/catg.d/p2130.pdf. Accessed September 13, 2017.
• Recommended immunization schedule for children and adolescents aged 18 years or younger, United States, 2017. CDC website. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html. Accessed September 16, 2017.
• Hepatitis B FAQs for the public. CDC website. https://www.cdc.gov/hepatitis/hbv/bfaq.htm. Accessed September 16, 2017.