Hepatitis B birth dose vaccines

WHO recommends that all infants (including low birth weight and premature infants) receive the first dose of hepatitis B vaccine as soon as possible after birth, ideally within 24 hours. If administration within 24 hours is not feasible, a late birth dose should be given at the first contact with a health-care provider, up to the time of the next dose in the primary schedule.^{Go to footnote 11}

Since perinatal or early postnatal transmission is the most important source of chronic HBV infection globally, WHO recommends that all infants (including low birth weight and premature infants) receive their first dose of hepatitis B vaccine as soon as possible after birth, ideally within 24 hours. If administration within 24 hours is not feasible, a late birth dose has some effectiveness.^{Go to footnote 11}

Although effectiveness declines progressively in the days after birth, after seven days, a late birth dose can still be effective in preventing horizontal transmission and therefore remains beneficial.^{Go to footnote 11}

The birth dose should be followed by two or three additional doses to complete the primary series. Both of the following options are considered appropriate: (i) a 3-dose schedule of hepatitis B vaccine, with the first dose (monovalent) being given at birth and the second and third (monovalent or as part of a combined vaccine) given at the same time as the first and third doses of DTP-containing vaccine; or (ii) four doses, where a monovalent birth dose is followed by three (monovalent or combined vaccine) doses, usually given with other routine infant vaccines; the additional dose does not cause any harm.

The interval between doses should be at least four weeks.^{Go to footnote 11}