Perinatal Hepatitis B
The American Academy of Pediatrics Committee on Infectious Diseases and the Committee on Fetus and Newborn support removal of permissive language for delaying the birth dose of hepatitis B vaccine and endorse the recommendation of the ACIP for giving the birth dose within the first 24 hr of life in all medically stable infants weighing ≥2000 g.
Identify HBsAg-positive mothers before delivery and document maternal HBsAg status in infant records.
Resolve unknown HBsAg status of mothers as soon as possible around delivery, and document maternal status in infant records.
For all infants born to HBsAg-positive mothers, administer both hepatitis B vaccine and HBIG within 12 hr of birth, regardless of any maternal antenatal treatment with antiviral medications.
For all infants with birth weight ≥2000 g born to HBsAg-negative mothers, administer hepatitis B vaccine as a universal routine prophylaxis within 24 hr of birth.
For all infants with birth weight less than 2000 g born to HBsAg-negative mothers, administer hepatitis B vaccine as a universal routine prophylaxis at 1 mo of age or at hospital discharge (whichever is first).
For all infants born to HBsAg-unknown mothers, administer hepatitis B vaccine within 12 hr of birth, and (1) for infants with birth weight ≥2000 g, administer HBIG by 7 days of age or by hospital discharge (whichever occurs first) if maternal HBsAg status is confirmed positive or remains unknown; (2) for infants with birth weight less than 2000 g, administer HBIG by 12 hr of birth unless maternal HBsAg status is confirmed negative by that time.
For further reading, see Pediatric Hepatitis B
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Cite this: John Anello, Brian Feinberg, John Heinegg, et. al. New Clinical Practice Guidelines, September 2017 - Medscape - Sep 15, 2017.