Yes, most hospitals give a hepatitis B shot soon after birth; other newborn protections depend on season, location, and risk.
Parents often ask what shots or protections a baby gets before leaving the maternity unit. The short answer at most birth centers is a single vaccine dose against hepatitis B, given in the first day of life. In some countries and risk settings, babies may also receive protection against tuberculosis or get an antibody against RSV during the respiratory season. This guide spells out what happens, why timing matters, and how to plan the next steps.
Vaccines Given Right After Delivery: What To Expect
The routine vaccine given in the nursery is hepatitis B. It’s a monovalent dose placed in the thigh. The goal is to start protection right away and block silent transmission. If the birth parent carries hepatitis B, the newborn may also receive a separate antibody (HBIG) during the first 12 hours and will still need the standard vaccine series later. Some regions add tuberculosis protection (BCG) soon after birth for babies who live where TB risk is high or who have household links to high-incidence areas. During RSV season, many U.S. hospitals also offer a one-time RSV antibody dose for qualifying infants before discharge when the birthing parent did not receive the maternal RSV vaccine.
Newborn Hospital Preventive Care At A Glance
The items below are common in the first day or two. Only some are vaccines; the others are routine preventive care that often gets asked about at the same time.
| Item | What It Prevents | Who/When |
|---|---|---|
| Hepatitis B shot (monovalent) | Hepatitis B virus infection and chronic liver disease | Given within 24 hours in most hospitals; preterm timing may vary |
| HBIG (antibody) | Added protection if the birth parent has hepatitis B | Within 12 hours when parent tests positive or status is unknown at delivery |
| BCG (where used) | Severe forms of TB in early life | Infants in high-TB settings or targeted groups; timing near birth |
| RSV antibody dose | Severe RSV illness in the first season | Newborns during RSV season when the maternal RSV vaccine was not given |
| Vitamin K (not a vaccine) | Bleeding due to low vitamin K | Single shot soon after birth |
| Erythromycin eye ointment | Eye infection from exposure during birth | Soon after delivery based on local rules |
Why The First Hepatitis B Dose Happens So Early
Hepatitis B can pass silently during birth or early caregiving. Infections acquired in infancy carry a high chance of becoming long-term, which raises future risks for cirrhosis and liver cancer. Starting protection before the first day ends closes that window. In U.S. guidance, medically stable infants weighing at least 2,000 grams receive the dose within 24 hours; smaller or medically unstable babies follow special timing based on weight and stability. The dose at birth doesn’t finish the job; your baby will still need the remaining doses at routine well-child visits.
Hospitals also add HBIG when the parent tests positive for hepatitis B surface antigen. HBIG is given in a separate limb and works right away while the vaccine trains the immune system over time. If test results are pending or unknown, many nurseries proceed with the vaccine at once and follow up with HBIG if a positive result returns.
Want to check the schedule in plain language? See the CDC’s current child and adolescent immunization schedule (PDF), which lists timing, special situations, and interval rules.
Where TB Protection Fits In Near Birth
Many high-income countries no longer give BCG to every newborn, but they still target babies at higher risk. Policies look at local TB rates and family ties to places where TB is common. When a baby qualifies, the dose is often given around the first month or before discharge in areas with higher risk, with the goal of guarding against severe TB forms like TB meningitis in early life. Parents in the U.K., for instance, can review the NHS page that explains who gets BCG and when. The practical takeaway: ask your midwife, pediatrician, or public health nurse whether your baby meets criteria in your area.
Read the NHS guidance on the BCG vaccine for tuberculosis to see typical criteria used in a low-incidence country.
RSV Protection In The Nursery During Season
RSV fills pediatric wards each winter. Two ways now protect young infants: a maternal vaccine during pregnancy or a long-acting antibody given to the baby. If the maternal vaccine wasn’t received, many U.S. hospitals offer the baby’s antibody dose before discharge during the season. The goal is to reduce the chance of severe lung infection and hospitalization across the first months at home. Timing depends on the local season start dates and supply. If your due date falls in season, ask your team whether the nursery can provide the dose, or whether you’ll get it at the first outpatient visit.
CDC’s page on infant protection explains timing windows and eligibility for this antibody option. Review the guidance here: RSV immunization for infants.
What Happens If A Baby Is Preterm Or Unwell
Some newborns need extra time in the nursery or NICU. For those under 2,000 grams or not yet medically stable, the hepatitis B shot might be timed for one month of age or at discharge, whichever comes first. Babies of hepatitis B-positive parents still get HBIG promptly, even if the vaccine is delayed for clinical reasons. Teams document these plans, so ask for the schedule in writing before discharge.
If an RSV antibody is planned, timing will depend on weight, season, and the unit’s protocol. BCG policies in preterm infants vary by region and by the infant’s clinical course; staff will share the target date once the baby is ready.
Your Next Steps After Leaving The Hospital
The first dose sets the stage for the routine series. Expect well-child visits at about 1–2 months and 6 months when the remaining hepatitis B doses are given along with other early-life vaccines. The office will track intervals, brands, and any catch-up needs. Bring the hospital record to the first visit so the office can document exactly what was given and when. If you relocate or switch clinics, keep a copy of the shot record and the discharge summary in your files.
How Pediatric Teams Keep Things On Track
- Screening and consent: Staff confirm the birth parent’s hepatitis B result and explain each medication or shot before administration.
- Two-step protection for hepatitis B exposure: If the parent is positive, baby receives HBIG and the vaccine dose in separate limbs.
- Documentation: Lot numbers, dates, and injection sites get recorded in the chart and in your baby’s immunization card.
- Follow-up plan: The discharge packet lists upcoming doses with target dates and clinic contact details.
Common Myths And Clear Facts
“Newborns Don’t Need Hepatitis B Protection Yet.”
Household spread can happen during close contact, not only at birth. A tiny scratch or exposure to body fluids is all it takes. The first-day dose starts protection before exposure can occur. CDC schedule notes specify the exact timing, including special rules for low birth weight or unknown maternal status, to keep coverage consistent across nurseries.
“BCG Is Universal Everywhere.”
Not true. BCG near birth is common where TB rates are high or in families linked to high-incidence regions. Low-incidence countries often use a targeted policy that focuses on risk factors, which means many babies won’t receive it. Local guidance decides who qualifies.
“RSV Shots At Birth Are For Everyone.”
Newborn RSV protection is reserved for specific situations: season timing, maternal vaccine status, and infant risk. Many babies receive the antibody in the hospital only during the season, while others get it at the first pediatric visit.
Dose Timing And Catch-Up: Practical Details
After the hospital, the office vaccine series continues on a set timetable. If a dose is late, clinics follow catch-up rules rather than restarting a series. This avoids extra shots and keeps immunity on track. Your baby’s clinician uses the same national tables to calculate minimum intervals and the earliest safe dates.
Typical Early-Life Protection Timeline
| Age | What’s Commonly Given | Notes |
|---|---|---|
| Birth | Hepatitis B; HBIG if exposed | Given in hospital; small or unstable infants follow special timing |
| Birth to 1 month | BCG in qualifying regions | Targeted by country policy and risk |
| During RSV season | Infant RSV antibody when maternal vaccine not given | Often before discharge or at the first visit |
| 1–2 months visit | Second hepatitis B dose with routine infant series | Intervals follow national tables and brand rules |
| 6 months visit | Final hepatitis B dose (3rd or 4th based on product) | Minimum age 24 weeks for the last dose |
Global Variations You Might See
Hospitals follow national policies shaped by local disease patterns and program logistics. The core themes are the same: start hepatitis B protection in the newborn period, add BCG where TB risk calls for it, and use RSV season tools to keep small lungs safe. In some low-resource settings, a birth dose of oral polio vaccine may appear on the card as an early “zero dose” linked to eradication campaigns; this depends on national programs and international guidance.
For a sense of worldwide coverage trends and where babies miss early protection, see the WHO/UNICEF immunization data. The global immunization coverage fact sheet provides current estimates and context for first-year vaccines.
How To Prepare Before Delivery Day
Confirm The Birth Parent’s Hepatitis B Status
Prenatal care includes a blood test for hepatitis B. Keep a copy with your hospital paperwork. If the result is positive or unknown at admission, the team will act quickly with HBIG and a vaccine dose for the baby.
Ask About NICU Or Early-Discharge Plans
If you expect a preterm birth or an early discharge, ask how the nursery handles timing for the first hepatitis B dose, RSV antibody during season, and BCG when applicable. Request the shot record and the next-dose due dates in writing.
Know Your Region’s TB Policy
Families with ties to high-TB regions should ask whether BCG is offered locally and when it’s scheduled. Clinics usually require a quick risk screen and may arrange the dose at a public health clinic if the hospital doesn’t stock it.
Evidence Snapshot: Why Timing Works
Newborn hepatitis B protection prevents infections that could last a lifetime. The CDC schedule update pages and ACIP briefing materials reiterate the within-24-hours approach, including steps when the parent’s status is unknown. These documents also lay out dose intervals and the final dose age, which helps offices plan catch-up without restarting. For RSV, CDC pages describe the use of long-acting antibodies at birth during season, a strategy supported by early real-world studies showing strong protection against hospitalization.
Plain-Language Takeaways For Parents
- Expect one shot right away: The hepatitis B dose usually happens within the first 24 hours.
- Extra step when exposed: Babies of hepatitis B-positive parents get HBIG and the vaccine dose promptly.
- TB policies differ: BCG near birth is targeted to higher-risk babies or regions with more TB.
- RSV season adds an option: If the maternal vaccine wasn’t given, an infant antibody dose may be offered before discharge during season.
- Keep the card handy: Bring the hospital record to the first clinic visit so the office can schedule the next doses.
Checklist To Bring To The Hospital
- Copy of the prenatal hepatitis B test result
- Insurance card and pediatrician contact
- Birth plan note that you want the newborn shot record before discharge
- Questions list: RSV season plan, BCG eligibility, and timing if baby is preterm
Final Word For Peace-Of-Mind
The first day in the nursery is busy, but vaccine and antibody decisions follow clear rules. Start hepatitis B protection on day one, add HBIG when needed, follow regional advice for BCG, and use RSV tools during the season. Leave with the dates for the next doses and you’ll stay right on track.