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Hepatitis B vaccine at birth

hepatitis; hepatitis b; immunisation; vaccination; vaccine; schedule; birth; neonatal;

Hepatitis B is a virus that can cause a serious infection - either acute (short-lived illness) or chronic (long term) infection of the liver. 

  • Before you are discharged from hospital you will be offered the first of four Hepatitis B vaccinations for your baby. It is strongly recommended that your baby have this vaccination. Hepatitis B vaccination is a very safe and effective way of protecting a baby against this serious infection.
  • The next vaccinations for hepatitis B and other infections are given at 6 weeks. Information about the schedule for South Australia is in our Immunisation topic on the Parenting and Child Health section of our website.

More information about hepatitis B and immunisation of babies

Immunise Australia program 

Department of Health South Australia


Contents of this topic

Before you are discharged from hospital you will be offered the first of four Hepatitis B vaccinations for your baby. It is strongly recommended that your baby have this vaccination.

Hepatitis B vaccination is a very safe and effective way of protecting a baby against this serious infection.

What is hepatitis B?

  • Hepatitis B is a virus that can cause either acute (short-lived illness) or chronic (long term) infection of the liver.
  • Babies who get this disease may only have mild or no symptoms. However most of these babies will go on to be chronic carriers and can pass the virus onto others.
  • As many as 1 in 4 hepatitis B carriers may develop liver cancer or liver failure much later in life.

In Australia, about 1 person in every 100 is a carrier of hepatitis B. Some people do not know that they are carriers.

For more information about hepatitis B, have a look at this information

How is hepatitis B spread?

The hepatitis B virus is found in infected body fluids including blood, semen, vaginal secretions, saliva and breast milk. Babies whose mothers have the hepatitis B virus are at a very high risk of being infected with the disease at birth.

Hepatitis B can be spread by:

  • blood to blood contact during a birth,
  • blood to blood contact from cuts or sores, sharing razors or tooth brushes, needle stick injuries, contaminated needles and syringes when injecting drugs, and contaminated instruments such as those used for body piercing)
  • sexual contact
  • breast feeding

Can hepatitis B be prevented?

Yes. Immunisation with the hepatitis B vaccine provides protection in most cases (95% of babies).

Free hepatitis B immunisation of babies in Australia is part of a long-term prevention strategy

  • to reduce the total amount of hepatitis B disease in Australia,
  • to reduce the illness and death from complications due to the disease
  • to eventually eliminate hepatitis B from Australia.

How many doses do babies receive?

  • With your consent, your baby will be given a dose of the hepatitis B vaccine before you leave hospital.
  • Your baby will be given three more doses of the hepatitis B vaccine to be fully immunised. These 3 doses will be given at 2, 4 and 6 months of age in combination with other routine childhood immunisations so your baby will not receive any additional needles.

Why do babies need to be immunised at birth?

The birth dose of hepatitis B vaccine is recommended by the National Health and Medical Research Council because:

  • the risk of chronic infection is highest in the young: 90% for babies, 50% for children and less than 10% for adults
  • 30% of hepatitis B infections are not associated with a known or disclosed high risk activity
  • hepatitis B vaccine works better in babies compared to older children and adults
  • a baby of a hepatitis B carrier mother is at high risk of being infected at birth. Immunisation can prevent the mother giving the infection to her baby (in 75-95% of cases) if the mother is a hepatitis B carrier and this is unknown.

Sometimes it is not known that the mother is a hepatitis B carrier because:

  • some mothers miss being tested for hepatitis B in pregnancy
  • sometimes the mothers blood test results are missing, inaccurate or recorded wrongly
  • mothers at high risk for getting hepatitis B disease may miss having their second hepatitis B test which should be done close to labour (hepatitis B can take 1-9 months to show up in a blood test from the day of infection)

The birth dose of hepatitis B vaccine is also recommended because:

  • it reduces the risk of babies getting hepatitis B disease from a household member who is a hepatitis B carrier (this is not always known)
  • "at risk" babies may otherwise miss out on having the vaccine
  • it provides some protection from hepatitis B disease for babies who may be late with their 2 month immunisation.

Is it safe?

It is safe to give the hepatitis B vaccine at birth.

  • Babies are exposed daily to substances that may cause an immune response which protects the body.
  • Hepatitis B vaccine is not a live vaccine and it provides protection without causing disease. It is produced in yeast cells and is free of animal or human blood products. No mercury is contained in the vaccine.

Premature babies

  • Premature babies are more prone to infections and in general should be immunised at the normal time.
  • Babies born less than 32 weeks gestation may have a lower immune response to hepatitis B vaccine. These babies should have a blood test after their 4th dose of hepatitis B vaccine to check if they have adequate protection and if not an extra booster dose of hepatitis B vaccine will be offered at 12 months of age.

A baby who is on antibiotics

  • Immunisation should only be postponed if a baby is very unwell or has a high fever over 38.5ºC. Being on antibiotics is not a reason to delay hepatitis B immunisation.

A sick baby

If a baby is too sick to receive the birth dose of hepatitis B, when can it be given?

  • The benefits of giving the birth dose can still be gained if the hepatitis B vaccine is given within the first seven days of life.
  • If this cannot be done the baby will start the course of hepatitis B vaccines with other childhood vaccines beginning at 2 months of age.

Is the protection long lasting?

  • Babies who have been fully immunised against hepatitis B will not require boosters.
  • There is good evidence to show that babies who complete a course of hepatitis B immunisations have long lasting protection.

Are there any side effects?

Serious side effects from hepatitis B vaccine are rare.

The most common side effects of the vaccine are minor and disappear quickly. These include

  • Soreness at the injection site,
  • Mild fever and joint pain.
  • Your baby may also be irritable or refuse feeds for a short time.

If you are concerned about your baby’s health after immunisation consult your midwife, doctor or immunisation nurse.

Getting more information in South Australia

Information in other languages

NSW Multicultural Health Communications Service 'Injections for newborn babies - why they're important 


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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see your doctor or midwife.


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