TABLE 1.

Hepatitis B Immunoprophylaxis Scheme for PT and LBW Infants*

Maternal StatusInfant ≥2000 gInfant <2000 g
HBsAg positiveHepatitis B vaccine + HBIG (within 12 h of birth)Hepatitis B vaccine + HBIG (within 12 h of birth)
Immunize with 3 vaccine doses at 0, 1, and 6 mo of chronologic ageImmunize with 4 vaccine doses at 0, 1, 2–3, and 6–7 mo of chronologic age
Check anti-HBs and HBsAg at 9–15 mo of ageCheck anti-HBs and HBsAg at 9–15 mo of age
If infant is HBsAg and anti-HBs negative, reimmunize with 3 doses at 2-mo intervals and retestIf infant is HBsAg and anti-HBs negative, reimmunize with 3 doses at 2-mo intervals and retest
HBsAg status unknownHepatitis B vaccine (by 12 h) + HBIG (within 7 days) if mother tests HBsAg positiveHepatitis B vaccine + HBIG (by 12 h)
Test mother for HBsAg immediatelyTest mother for HBsAg immediately and if results are unavailable within 12 h, give infant HBIG
HBsAg negativeHepatitis B vaccine at birth preferredHepatitis B vaccine dose 1 at 30 days of chronologic age if medically stable, or at hospital discharge if before 30 days of chronologic age
Immunize with 3 doses at 0–2, 1–4, and 6–18 mo of chronologic ageImmunize with 3 doses at 1–2, 2–4, and 6–18 mo of chronologic age
May give hepatitis B-containing combination vaccine beginning at 6–8 wk of chronologic ageMay give hepatitis B-containing combination vaccine beginning at 6–8 wk of chronologic age
Follow-up anti-HBs and HBsAg testing not neededFollow-up anti-HBs and HBsAg testing not needed
  • * Extremes of gestational age and birth weight no longer a consideration for timing of HBV doses.

  • Some experts prefer to perform serologic testing 1 to 3 months after completion of the primary series.