Newborns typically are given the first dose of hbv vaccine before they are discharged home.

Newborns typically are given the first dose of hbv vaccine before they are discharged home.
Newborns typically are given the first dose of hbv vaccine before they are discharged home.

​Some parents of preterm and low birth weight babies are concerned about immunizing their newborns according to the standard schedule created by the American Academy of Pediatrics (AAP) and other medical organizations. Their main worry is whether the recommendations were made with full-term, normal weight babies in mind and whether the same guidelines apply to their own newborns. Parents may think that their newborns are just too fragile to be vaccinated because of low birth weight and possible health problems that came with their baby's preterm birth.

Your pediatrician will tell you that all of these babies should be given the routinely recommended childhood vaccinations. They should get every immunization on the standard schedule when they reach the ages at which these shots are normally given to all children.

If you're uncertain, keep in mind:

  • If preterm babies get the infections that vaccines can prevent, they have a greater chance of having disease-related problems. See Weighing the Risks and Benefits.

  • All of the available vaccines are safe when given to preterm and low birth weight babies.

  • Any side effects associated with the vaccines are similar in both full-term and preterm babies.

The hepatitis B vaccine deserves special mention.

Newborns should receive their first dose of hepatitis B vaccine within the first 24 hours of birth. Newborns who for a medical or other reason did not get the vaccine at birth should get their first dose as soon as possible, and complete all 3 doses at the recommended intervals. 

If a pregnant woman tests positive for HBV during routine prenatal screening or at the time of delivery, her child must receive the first dose of hepatitis B vaccine within 12 hours of birth. The second dose should be given at 1 month of age, and the final dose by 6 months of age. 

Note: The AAP recommends that all medically stable preterm babies with a minimum birth weight of 2000 grams (about 4 lbs., 6 oz.) be treated like full-term babies and receive the first dose of the hepatitis B immunization according to the recommended childhood immunization schedule. If birth weight is less than 2000 g, the AAP recommends administering the hepatitis B vaccine at one month of age or at the time of discharge from the hospital – whichever comes first.​

Additional Information from HealthyChildren.org:

  • How to Cocoon a Newborn: Only an E-Mail Away!

  • Your Child's First Vaccines: What You Need to Know (VIS)

  • Hepatitis B Vaccine: What Parents Need to Know​

  • Hepatitis B Vaccine: What You Need to Know (VIS)

Last Updated8/23/2017SourceCommittee on Infectious Diseases (Copyright © 2017 American Academy of Pediatrics)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

The infection occurs during delivery if the mother is infected. However, newborns may become infected after birth from other sources, such as the mother's saliva, stool, urine, or breast milk.

  • Treatment of symptoms and good nutrition

  • Vaccination

  • Sometimes immune globulin

Doctors treat the problems caused by hepatitis B virus infection. It is especially important for affected newborns to receive good nutrition.

All newborns, whether or not infected, are given the first dose of the hepatitis B virus vaccine before they are discharged from the hospital.

Newborns born to an infected mother are also given hepatitis B immune globulin, a preparation of antibodies against hepatitis B. The first dose of the vaccine and the immune globulin are given within 12 hours of birth.

Routine Vaccinations for Infants, Children, and Adolescents

Routine Vaccinations for Infants, Children, and Adolescents

Following the recommended vaccination schedule is important because it helps protect infants, children, and adolescents against infections that can be prevented. The schedule below is based on the ones recommended by the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC; see also the CDC schedule for infants and children [birth through 6 years] and the CDC schedule for older children [7 to 18 years old]). The schedule below indicates which vaccines are needed, at what age, and how many doses (indicated by the numbers in the symbols).

There is a range of acceptable ages for many vaccines. A child's doctor can provide specific recommendations, which may vary depending on the child's known health conditions and other circumstances. Often, combination vaccines are used so that children receive fewer injections. If children have not been vaccinated according to the schedule, catch-up vaccinations are recommended, and parents should contact a doctor or health department clinic to find out how to catch up. Parents should report any side effects after vaccinations to their child's doctor.

For more information about this schedule and other vaccination schedules, parents should talk to a doctor or visit the Centers for Disease Control and Prevention's Vaccines & Immunizations web site.

Newborns typically are given the first dose of hbv vaccine before they are discharged home.

[a] Hepatitis B vaccine Hepatitis B Vaccine The hepatitis B vaccine helps protect against hepatitis B and its complications ( chronic hepatitis, cirrhosis, and liver cancer). Generally, hepatitis B is more serious than hepatitis A and... read more : This vaccine is given to most newborns before they are discharged from the hospital. The first dose is typically given at birth, the second dose at age 1 to 2 months, and the third dose at age 6 to 18 months. Infants who did not receive a dose at birth should begin the series as soon as possible.

[b] Rotavirus vaccine Rotavirus Vaccine The rotavirus vaccine is a live-virus vaccine that helps protect against gastroenteritis caused by rotavirus, which causes vomiting, diarrhea, and, if symptoms persist, dehydration and organ... read more : Depending on the vaccine used, two or three doses of the vaccine are required. With one vaccine, the first dose is given at age 2 months and the second dose at age 4 months. With the other vaccine, the first dose is given at age 2 months, the second dose at age 4 months, and the third dose at age 6 months.

[c] Haemophilus influenzae type b (Hib) vaccine Haemophilus influenzae Type b Vaccine The Haemophilus influenzae type b (Hib) vaccine helps protect against bacterial infections due to Hib, such as pneumonia and meningitis. These infections may be serious in children. Use... read more : Depending on the vaccine used, three or four doses of the Hib vaccine are required. With one vaccine, the first dose is given at age 2 months, the second dose at age 4 months, and the third dose at age 12 to 15 months. With the other vaccine, the first dose is given at age 2 months, the second dose at age 4 months, the third dose at age 6 months, and the fourth dose at age 12 to 15 months.

[d] Poliovirus vaccine Polio Vaccine The polio vaccine protects against polio, a very contagious viral infection that affects the spinal cord and brain. Polio can cause permanent muscle weakness, paralysis, and sometimes death... read more : Four doses of the vaccine are given. The first dose is given at age 2 months, the second dose at age 4 months, the third dose at age 6 to 18 months, and the fourth dose at age 4 to 6 years.

[e] Diphtheria, tetanus, and acellular pertussis (DTaP) vaccine Diphtheria-Tetanus-Pertussis Vaccine The diphtheria, tetanus, and pertussis vaccine is a combination vaccine that protects against these three diseases: Diphtheria usually causes inflammation of the throat and mucous membranes... read more : Before age 7, children are given the DTaP preparation. Five doses of DTaP are given. The first dose is given at age 2 months, the second dose at age 4 months, the third dose at age 6 months, the fourth dose at age 15 to 18 months, and the fifth dose at age 4 to 6 years.

DTaP is followed by one dose of a tetanus, diphtheria, and pertussis (Tdap) Administration The tetanus-diphtheria (Td) vaccine protects against toxins produced by the tetanus and diphtheria bacteria, not against the bacteria themselves. There is also a combination vaccine that adds... read more booster given at age 11 to 12 years (shown as the number 6 on the above schedule). This dose is followed by a tetanus-diphtheria or Tdap booster every 10 years.

[f] Pneumococcal vaccine Pneumococcal Vaccine Pneumococcal vaccines help protect against bacterial infections caused by Streptococcus pneumoniae (pneumococci). Pneumococcal infections include ear infections, sinusitis, pneumonia... read more : Four doses of the vaccine are given. The first dose is given at age 2 months, the second dose at age 4 months, the third dose at age 6 months, and the fourth dose at age 12 to 15 months.

[g] Meningococcal vaccine Meningococcal Vaccine The meningococcal vaccine protects against infections caused by the bacteria Neisseria meningitidis (meningococci). Meningococcal infections can lead to meningitis (an infection of tissue... read more : Two doses of the vaccine are given. The first dose is given at age 11 to 12 years and the second dose at age 16 years (not shown on the above schedule).

[h] Influenza (flu) vaccine Influenza Vaccine The influenza virus vaccine helps protect against influenza. Two types of influenza virus, type A and type B, regularly cause seasonal epidemics of influenza in the United States. There are... read more : The influenza vaccine should be given yearly to all children, beginning at age 6 months. There are two types of vaccine available. One or two doses are needed, depending on age and other factors. Most children need only one dose. Children who are 6 months to 8 years old who have received fewer than two doses or whose influenza vaccination history is unknown should receive two doses at least 4 weeks apart.

[i] Measles-mumps-rubella (MMR) vaccine Measles, Mumps, and Rubella Vaccine The measles, mumps, and rubella (MMR) vaccine is a combination vaccine that helps protect against these three serious viral infections. The vaccine contains live but weakened measles, mumps... read more : Two doses of the vaccine are given. The first dose is given at age 12 to 15 months and the second dose at age 4 to 6 years.

[j] Varicella (chickenpox) vaccine Varicella Vaccine The varicella vaccine helps protect against chickenpox (varicella), a very contagious infection caused by the varicella-zoster virus. It causes an itchy rash that looks like small blisters with... read more : Two doses of the vaccine are given. The first dose is given at age 12 to 15 months and the second dose at age 4 to 6 years.

[k] Hepatitis A vaccine Hepatitis A Vaccine The hepatitis A vaccine helps protect against hepatitis A. Typically, hepatitis A is less serious than hepatitis B. Hepatitis A often causes no symptoms, although it can cause fever, nausea... read more : Two doses of the vaccine are needed for lasting protection. The first dose is given between ages 12 to 23 months, and the second dose 6 months after the first. All children over age 24 months who have not been vaccinated should be given 2 doses of the hepatitis A vaccine.

[l] Human papillomavirus (HPV) vaccine Human Papillomavirus (HPV) Vaccine The human papillomavirus (HPV) vaccine helps protect against infection by the strains of HPV that are most likely to cause the following: Cervical cancer, vaginal cancer, and vulvar cancer in... read more : Routine vaccination is recommended at age 11 to 12 years (can start at age 9 years) and for previously unvaccinated or not adequately vaccinated people up through age 26 years (not shown on the above schedule). The human papillomavirus vaccine is given to girls and boys in 2 or 3 doses. The number of doses depends on how old the child is when the first dose is given. Those given the first dose at age 9 to 14 years are given 2 doses, separated by at least 5 months. Those given the first dose at age 15 years or older are given 3 doses. The second dose is given at least 1 month after the first, and the third dose is given at least 5 months after the first dose.