For Hep B Vaccine, the Sooner the Better

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By Joanna Parga-Belinkie, MD

Hepatitis B is the first vaccine we give to infants. Where I work as director of the well baby nursery at the Hospital of the University of Pennsylvania, we try to get this vaccine delivered to baby at 12 hours of life. Giving this vaccine means a lot to families. It’s the first time we are teaching the baby’s immune system about infection, the initial vaccination in the infant series, and the beginning of counseling and teaching about vaccination in general.

When parents are hesitant about this vaccine or refuse it, we always make sure to have a conversation with them about why we give it in the hospital. The points we emphasize center around recommendations made by the American Academy of Pediatrics in 2017. A policy statement released at that time stressed the importance of this vaccine in the first 24 hours of life.

We inform families that even when birth parents are tested for hepatitis B, there are rare cases of transmission in the home we can’t account for. So, the vaccine acts as great initial protection. We also let families know that if infected in infancy, the chances this form of hepatitis will become chronic are extremely high. With chronic liver disease comes cirrhosis and a cancer risk. Therefore, this vaccine is effective in helping to prevent a common form of liver cancer.

Even with good evidenced-based information and counseling, we know families don’t have the relationship with neonatologists in the hospital that they have with their pediatricians. Many families we discuss the vaccine with want to wait to go to their pediatrician’s office. This is either because they were told to wait, or they just want the trusted guidance of their family physician.

So, we need your help!

We want to find ways to make sure infants begin their vaccine journey with us at the Hospital of the University of Pennsylvania or at the baby’s birth hospital for those delivered elsewhere. If you have any feedback on how we counsel, or suggestions on how we could partner with you to discuss the importance of hepatitis B vaccination in the first 24 hours of life, we welcome your insightful efforts to improve infant care.

Joanna Parga-Belinkie, MD, is an attending neonatologist at the Hospital of the University of Pennsylvania (HUP) and at Children’s Hospital of Philadelphia. She is director of the newborn nursery at HUP and can be reached at