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 Beth C. Natt, MD, system medical director of the Pediatric Service Line and chair of Pediatrics at Goryeb Children’s Hospital at Atlantic Health. “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. Although many people associate hepatitis B with sexual contact or blood exposure, Dr. Natt explains that infants and young children are the ones at highest risk of developing this chronic infection if they’re exposed to it.

“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

Dr. Natt explains that 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

“Up to 90% of infants who are infected by the virus develop chronic hepatitis B, which can silently damage their liver slowly over time and lead to long-term issues such as cirrhosis, liver failure and liver cancer,” says Dr. Natt. “This is why early immunization matters. The birth dose vaccine schedule protects babies before there’s any potential chance of exposure.”

Following the expert recommendations

Dr. Natt 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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