Which immunization protocol should be followed by a nurse administering a hepatitis B vaccine to an infant whose mother is diagnosed HBsAg positive during pregnancy?

All pregnant women should be tested for HBsAg during an early prenatal visit in each pregnancy, and all HBsAg-positive pregnant women should be tested for HBV DNA to guide the use of maternal antiviral therapy during pregnancy.

N/A=not available

*This CPT code corresponds only to the HBsAg screening component; additional CPT codes might be associated with other component tests.

Notes: CDC recommends healthcare providers use prenatal HBsAg tests (vs. non-specific tests) for pregnant women, which allows for reporting of positive results along with pregnancy status to public health jurisdictions. Refer all HBsAg positive pregnant women to Perinatal Hepatitis B Prevention Program coordinators for case management of mother and infant: https://www.cdc.gov/vaccines/vpd/hepb/hcp/perinatal-contacts.html.

Laboratories reserve the right to add, modify, or stop performing tests at any time – providers should review any test notifications from laboratories for changes.

What is the Hep B vaccine protocol?

*The schedule for hepatitis B is flexible, but minimal intervals and minimum ages need to be observed: There should be at least 4 weeks between doses 1 and 2, and at least 8 weeks between doses 2 and 3. The minimum interval for the overall series from dose 1 to final dose is 4 months (16 weeks).
Babies born to mothers infected with hepatitis B need to be given a dose of the hepatitis B vaccine within 24 hours of their birth, followed by further doses at 4, 8, 12 and 16 weeks of age, plus a final dose when they're 1 year old.

What should I do if hepatitis B is positive in pregnancy?

If you test positive for hepatitis B infection, then your newborn must be given proper prevention immediately in the delivery room, clinic or bedside: first dose (called "birth dose") of the hepatitis B vaccine. one dose of the Hepatitis B Immune Globulin (HBIG). *