Hepatitis B: Birth Dose Remains Recommended for All Newborns

Public Health Seattle & King County continues to recommend the hepatitis B vaccine birth dose for all infants, regardless of the birth parent’s hepatitis B infection status.

Providers should continue administering hepatitis B vaccine to all newborns, following the AAP-adapted clinical flowchart outlined in the recent Public Health Advisory.

Key Clinical Reminders

• Ensure infants complete the full 3–4 dose hepatitis B vaccine series by 18 months of age.
• For infants born to a parent who is hepatitis B–positive, perform post-vaccination serologic testing:
  • Timing: 1–2 months after completion of the vaccine series
  • Age requirement: Do not test before 9 months of age

This approach remains critical for preventing perinatal hepatitis B transmission and ensuring long-term protection.

Resources:

• AAP Immunization Schedule (American Academy of Pediatrics)
• Hepatitis B: The Disease and Vaccines (Children’s Hospital of Philadelphia)
• Viral Hepatitis in Pregnancy (American College of Obstetrics and Gynecology – login required)
• Hepatitis B (Washington State Department of Health)
• Elimination of Perinatal Hepatitis B: Providing the First Vaccine Dose Within 24 Hours of Birth (American Academy of Pediatrics)
• Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices (CDC)
• Universal Hepatitis B Vaccination at Birth: Safety, Effectiveness, and Public Health Impact (Vaccine Integrity Project)