Protecting Your Baby against Hepatitis B at Birth

HealthLinkBC File Number: 
Last Updated: 
November 2015
Keep your child safe.
Get all vaccines on time.
By getting all vaccines on time, your child can be protected from many diseases over a lifetime.

Immunization has saved more lives in Canada in the last 50 years than any other health measure.

What is the hepatitis B vaccine?

The hepatitis B vaccine protects against the hepatitis B virus. It is provided free to babies as part of their routine immunizations. The vaccine is approved by Health Canada.

What is hepatitis B?

Hepatitis B is a virus that attacks the liver. When babies get infected with hepatitis B, the virus is very likely to stay in the body forever. If the virus stays in the body for a long time, it can cause serious disease including permanent liver damage (cirrhosis). Hepatitis B is also one of the main causes of liver cancer, which can be fatal. This is why getting protection from the vaccine at a young age is important.

Who should get hepatitis B vaccine at birth?

The hepatitis B vaccine is given to a baby at birth if their mother has hepatitis B, or is at high risk of hepatitis B infection. A baby who has a household member or caregiver with hepatitis B should also get the vaccine at birth. For a list of those who are at higher risk of hepatitis B infection, see HealthLinkBC File #25a Hepatitis B Vaccine.

How is a baby protected against hepatitis B at birth?

When a mother is infected with hepatitis B, or at risk of infection, her baby will receive 2 immunizations at birth. One is hepatitis B immune globulin, which provides antibodies that protect against the hepatitis B virus right away. The other immunization is the hepatitis B vaccine, which helps the baby make their own antibodies. A baby whose mother is not infected but who has a household member or a caregiver with hepatitis B would get only the hepatitis B vaccine at birth.

After birth, the baby will receive 3 more doses of hepatitis B vaccine at 2, 4 and 6 months of age. These are given at the same time as other childhood vaccines. For more information, see HealthLinkBC File #105 Diphtheria, Tetanus, Pertussis, Hepatitis B, Polio and Haemophilus influenzae type b (DTaP-HB-IPV-Hib) Vaccine.

Babies immunized at birth need to have a blood test 4 weeks after their last dose of hepatitis B vaccine to make sure the vaccine has protected them.

Some babies who received hepatitis B vaccine at birth may be on a different immunization schedule. If you are unsure when your baby should be immunized or tested, speak with your health care provider. It is important to keep a record of all immunizations received.

For more information on hepatitis B immune globulin or the hepatitis B infant vaccine see HealthLinkBC File #25b Hepatitis B Immune Globulin and HealthLinkBC File #25c Hepatitis B Infant Vaccine.

What are the benefits of hepatitis B vaccine?

The hepatitis B vaccine is the best way to protect your child against hepatitis B and its complications. Complications include permanent liver damage, which can lead to liver cancer and death.

When you get your child immunized, you help protect others as well.

What are the possible reactions after the vaccine?

The vaccine is very safe. It is much safer to get the vaccine than to get hepatitis B.

Common reactions to the vaccine may include soreness, redness and swelling where the vaccine was given. Some children may experience fever, fussiness or fatigue.

Acetaminophen (e.g. Tylenol®) or ibuprofen* (e.g. Advil®) can be given for fever or soreness. ASA (e.g. Aspirin®) should not be given to anyone under 18 years of age due to the risk of Reye Syndrome.
*Ibuprofen should not be given to children under 6 months of age without first speaking to your health care provider.

For more information on Reye Syndrome, see HealthLinkBC File #84 Reye Syndrome.

It is important to stay in the clinic for 15 minutes after getting any vaccine because there is an extremely rare possibility, less than 1 in a million, of a life-threatening allergic reaction called anaphylaxis. This may include hives, difficulty breathing, or swelling of the throat, tongue or lips. Should this reaction occur, your health care provider is prepared to treat it. Emergency treatment includes administration of epinephrine (adrenaline) and transfer by ambulance to the nearest emergency department. If symptoms develop after you leave the clinic, call 9-1-1 or the local emergency number.

It is important to always report serious or unexpected reactions to your health care provider.

How is hepatitis B spread?

Hepatitis B is spread by contact with infected blood and some body fluids—for example during childbirth. Hepatitis B is also spread by sharing items that may have blood on them such as toothbrushes, razors, dental floss, nail files, needles used for injecting drugs, and by having unprotected sex with another person infected with the hepatitis B virus.

People living in the same household with someone who has hepatitis B are at higher risk of getting infected and they should get the hepatitis B vaccine. The vaccine is provided free to these people. Contact your health care provider to make an appointment. For more information on hepatitis B, see HealthLinkBC File #25a Hepatitis B Vaccine.

Can I breastfeed my baby if I have hepatitis B?

Yes, you can. There is no evidence that breastfeeding can spread hepatitis B from a mother to her baby.

For More Information

For more information on immunizations in B.C., see the B.C. Immunization Schedules or visit ImmunizeBC at

ImmunizeBC logo BCCDC logo

Is it an emergency?

If you or someone in your care has chest pains, difficulty breathing, or severe bleeding, it could be a life-threatening emergency. Call 9-1-1 or the local emergency number immediately.
If you are concerned about a possible poisoning or exposure to a toxic substance, call Poison Control now at 1-800-567-8911.

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