Why Does the Hepatitis B Vaccine at Birth Matter?

For many parents, the hours after birth are filled with joy—and decisions. Among them is whether to give your newborn the first dose of the hepatitis B vaccine. And many parents are turning to their pediatrician for thoughtful and honest answers.

“Pediatricians and public health experts continue to support the hepatitis B birth dose vaccine,” says April Graham, DO, a pediatrician at Atlantic Health.

Beth C. Natt, MD, system medical director of the Pediatric Service Line and chair of pediatrics at Atlantic Health Goryeb Children’s Hospital at Atlantic Health, agrees. She adds, “It’s important that parents understand the virus, how it spreads and why birth immunization helps prevent long-term, irreversible health problems.”

A snapshot of the health issue

Hepatitis B is a viral infection that attacks the liver and can lead to lifelong illness, liver failure and even liver cancer. Dr. Graham explains that while most adults recover from hepatitis B, up to 90% of infected infants develop chronic hepatitis B for which there is no cure, so early protection is essential.

“Prior to the United States rolling out routine infant vaccination in 1991, about 20,000 children each year were infected with hepatitis B,” says Dr. Natt. “About half of those came from infected mothers who passed the virus to their newborn baby. The other half of infected children contracted it through shared household spaces and daycare exposures.”

How babies are exposed

Hepatitis B is spread through blood and certain body fluids. The disease can live on surfaces for several days, and most infections cause no immediate symptoms. Because of this, families often don’t realize their child has been exposed.

Here are three common ways newborns and infants contract the virus:

During birth if the mother has hepatitis B
Through close household contact, even if no one appears sick
In childcare settings where small cuts, bites or shared items can cause the spread

“Many people mistakenly think of hepatitis B as an adult disease with transmission solely through sexual contact and blood exposure,” says Dr. Graham, “but babies are actually at the highest risk of developing lifelong infection if exposed.”

Following the expert recommendations

Dr. Graham encourages families to talk with their pediatrician about the hepatitis B vaccine and its recommended guidelines, which are as follows:

The first dose is given within 24 hours of birth before discharge from the hospital.
The second dose is administered at one to two months of age.
The third and final dose is administered at six months of age.

“We continue to follow recommendations set forth by the American Academy of Pediatrics (AAP), The Advisory Committee on Immunization Practices (ACIP) and The Centers for Disease Control and Prevention (CDC),” says Dr. Natt. “Their guidelines are based on decades of research that show the vaccine safely and effectively prevents perinatal and early childhood hepatitis B virus infection.”

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Published: January 26, 2026

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