Selective neonatal and routine infant hepatitis B immunisation schedule

Selective neonatal and routine infant hepatitis B immunisation schedule

Babies born to mothers who have screened positive for HBV in pregnancy, or whose mothers have acute hepatitis B infection in pregnancy, are offered an accelerated course of hepatitis B immunisation starting at birth and continuing as part of the routine childhood immunisation programme with hexavalent vaccine.

For this reason, timely administration of all doses of vaccine (+/-HBIG at birth if mother is assessed as higher infectivity), is vital in preventing the infant becoming infected with hepatitis B:

• the first dose of monovalent hepatitis B vaccine (+/-HBIG) should be given in hospital no later than 24 hours after birth
• the second dose of monovalent hepatitis B vaccine is given at 4-weeks of age
• the hexavalent vaccine (DTaP/IPV/Hib/HepB), (currently given as Infanrix hexa), including protection against hepatitis B is given at 8, 12 and 16 weeks of age as part of the routine childhood schedule
• a final dose of monovalent hepatitis B vaccine is offered at 12 months old along with a blood test (for HBsAg and anti-HBc) to ascertain if the baby has become infected with hepatitis B virus.

The schedule is detailed in the Green Book and summarised in Table below.

The mother's hepatitis B virus status and all doses of monovalent and combination hepatitis B vaccines that are administered to the infant must be recorded in the relevant pages of the Personal Child Health Record (PCHR) known as the 'Red Book', entered on the GP system, and reported to the local Child Health Information Service (CHIS) or CHRD (Child Health Records Department).

This acts as a central record of an infant's immunisation history and facilitates estimating vaccine uptake locally and nationally which are in turn used to evaluate effectiveness, impact and quality of the immunisation programme.

Table: Hepatitis B immunisation schedule for routine childhood and selective neonatal immunisation programmes following the introduction of hexavalent hepatitis B-containing vaccine (adapted from Green Book)

Reference:

• PHE (January 8th 2021). Guidance on the hepatitis B antenatal screening and selective neonatal immunisation pathway