. "4 Immunization." Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C. Washington, DC: The National Academies Press, 2010.
The following HTML text is provided to enhance online
readability. Many aspects of typography translate only awkwardly to HTML.
Please use the page image
as the authoritative form to ensure accuracy.
Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C
TABLE 4-2 Hepatitis B Immunization Management of Preterm Infants Who Weigh Less Than 2,000 g, by Maternal HBsAg Status—ACIP Recommendations
MaternalHBsAg Status
Recommendation
Positive
HBIG + hepatitis B vaccine (within 12 hours of birth) Continue vaccine series beginning at age of 1–2 months according to recommended schedule for infants born to HBsAg-positive mothers (see Table 4-1)
Do not count birth dose as part of vaccine series
Test for HBsAg and antibody to HBsAg after completion of vaccine series at age of 9–18 months (that is, next well-child visit)
Unknown
HBIG + hepatitis B vaccine (within 12 hours of birth)
Test mother for HBsAg
Continue vaccine series beginning at age of 1–2 months according to recommended schedule based on mother’s HBsAg result (see Table 4-1)
Do not count birth dose as part of vaccine series
Negative
Delay first dose of hepatitis B vaccine until age of 1 month or hospital discharge
Abbreviations: ACIP, Advisory Committee on Immunization Practices; HBIG, hepatitis B immune globulin; HBsAg, hepatitis B surface antigen.
SOURCE: Mast et al., 2005.
Recommendation 4-1. All infants weighing at least 2,000 grams andborn to hepatitis B surface antigen-positive women should receivesingle-antigen hepatitis B vaccine and hepatitis B immune globulin inthe delivery room as soon as they are stable and washed. The recommendations of the Advisory Committee on Immunization Practicesshould remain in effect for all other infants.
Administration of prophylaxis in the delivery room is not novel. In the United States, vitamin K prophylaxis for vitamin K–deficiency bleeding and tetracycline or erythromycin for prophylaxis of neonatal gonococcal infections are routinely given to infants in the delivery room (American Academy of Pediatrics, 1961, 1980; Workowski and Berman, 2006). The World Health Organization recommends that the birth dose of the hepatitis B vaccine be administered as soon after birth as possible (WHO, 2006). A pilot project in The Lao People’s Democratic Republic demonstrated almost 100% coverage when the hepatitis B vaccine was administered in
