Pros & Cons Newborn Hep B Vaccination

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At the hospital I am currently working at we are to ask the parents if they want the optional newborn hep B vacc. and try to get it administered (if they want it) within 12 hours of life. Many parents do not have a preferrence one way or the other about it and seem to rely on the nurse to tell them what to do. I want to provide my patients with a clear picture of the pros and cons of getting the vacc that early and in which situations would you definately want to or not want to give the shot. And why the 12 hour deadline. I know we have given it after the 12 hours before when the mom wanted to discuss it with doctor the next day but for the most part we are told to rush it. Any help out there with this topic would be greatly appreciated.

Specializes in NICU.
If the mom has it, but then it's too late for a vaccination.

Definitely not too late, as Jolie stated. That's why Hep B is always screened for, as is HIV ..... if you act quick the baby can have a drastically favorable outcome.

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Jolie is right. HBIg and the vaccine are indicated within the first twelve hours if mom tests positive for Hep B. Giving these DOES make a difference for the baby.

As for the first in the series of shots, we offer the injection (along with the teaching sheet) during the hospital stay and many parents take us up on it. For those who don't, we make certain that they understand they will need to have their babies vaccinated at the doctor's office before the baby is two months old.

Some parents/docs prefer to wait and use the Comvax, and that's fine with us. Those who chose the vaccine before discharge are not at all pressured into having the baby get the shot within the first twelve hours. They're already getting the vitamin K injection shortly after birth and possibly a circ (let's not start debating that on this thread, please). The Hep B can wait until close to d/c.

Only occasionally does someone say they don't want the vaccine at all.

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Specializes in Community, OB, Nursery.

We don't have any hard & fast rule about when HepB is given unless Mom is known HepB+ or unknown. If unknown, we give HepB within 12 hours. If mom is HepB+, we give HepB and HBIG within 12 hours.

Other than that, there's no real reason to rush a baby getting the vax. I'd say about 20% of our parents choose to wait til the first set of vaxes to start HepB. :up: If I had to go back and do things again, I'd do that too.

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I don't know where my brain went to...Sorry...I stand corrected and can't believe I said that! :(

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There is no pro unless a primary caregiver is Hep B positive. It's not given routinely here and when it is, it is done within 12 hours because someone caring for the baby is positive. zThey have started giving it when kids go to school but even them it's not required. The only time Hep B is required here is when entering med/nursing school here and that is because you are more exposed to it.

I am totally pro vac but unless they are high risk, I don't understand the reason behind giving these babies vaccines.

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Specializes in L&D,Lactation.

I too am an "l&doldtimer", I am pro vaccine also but have never understood why we started pushing this in the immediate newborn period. AAP guidelines for vitamin K and erythromycin is within the first 6 hours. I pushed one of ours peds also as to why and he said lack of compliance and that they wanted all kids vaccinated by the time they were adolescents and sexually active...there is a good long time in my mind between birth and adolescence to get your vaccines together, our patient population is EXTREMELY compliant and knowledgeable. Now they have to sign a consent and I mostly discourage them. I think it is too much in that very special first 2 hours, my priority is to get started on a successful breastfeeding relationship.

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Are you saying that you think Vitamin K and erythromycin should also be deferred? I hope not, as each of those has an immediate purpose.

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Specializes in Community, OB, Nursery.
Are you saying that you think Vitamin K and erythromycin should also be deferred? I hope not, as each of those has an immediate purpose.

Don't think so - think the point she was making (as I read it, anyway) was that even with the immediate purpose that Emycin/VitK serve, they've got 6 hours to do it, so why the big rush with HepB.

Recently we got this email that HepB consents (and I quote) "are to be signed by mom when newborn first goes to mom's room." I have a big issue with that, not because I'm anti-vax (I'm not) but that shouldn't be the priority at that moment. The last thing people need to be doing is reading more papers instead of meeting their new baby.

The second part was more of a rant on my part and not answering your question.....sorry.:saint:

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Specializes in OB L&D Mother/Baby.
Don't think so - think the point she was making (as I read it, anyway) was that even with the immediate purpose that Emycin/VitK serve, they've got 6 hours to do it, so why the big rush with HepB.

Recently we got this email that HepB consents (and I quote) "are to be signed by mom when newborn first goes to mom's room." I have a big issue with that, not because I'm anti-vax (I'm not) but that shouldn't be the priority at that moment. The last thing people need to be doing is reading more papers instead of meeting their new baby.

The second part was more of a rant on my part and not answering your question.....sorry.:saint:

A lot of our nurses have the moms read and sign before they even delivery. There are times when it's totally innapropriate. There are certain nurses that I work with that get upset if they take over on a patient for you at the end of the shift and it's not signed...

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Specializes in Community, OB, Nursery.

Oooh, that would NOT go over well with L/D at my place. And I don't blame them, as that's not really the time or place to be addressing the issue (which is essentially what you're saying, right?).

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Specializes in OB L&D Mother/Baby.
Oooh, that would NOT go over well with L/D at my place. And I don't blame them, as that's not really the time or place to be addressing the issue (which is essentially what you're saying, right?).

Right. I usually have more pertinent things to be discussing during the laboring process than vaccinations... I mean there is already the whole admission process, monitors, relaxation, pain options etc...

We are a combined unit so if it's not signed during labor it's the same nurses that can get it signed afterward. We generally labor and deliver and keep our same couplet thru the shift. Unless there's something crazy going on.

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