At birth

Why does my baby need a vaccine at birth?

Babies need to have the first hepatitis B vaccination at birth because many people who have hepatitis B don’t have any symptoms and don’t know they are infected. It is possible for a mother to have hepatitis B while she is pregnant and pass it on to her baby during the birth without knowing it. Even mothers who have had blood tests showing no sign of hepatitis B virus can be carrying hepatitis B and pass it on to their babies during the birth.1

About half of the children who catch hepatitis B get it during their births. People who catch hepatitis B while they are young babies almost always develop serious liver damage (cirrhosis) or cancer as adults and around a quarter of those people die from the disease.1

The other half catch it in early childhood from other people who carry the virus and often do not know they have it. It is rare for children to catch hepatitis B from other children but it can happen. Children can catch hepatitis B from another child who is carrying the virus. This can happen when young children bite one another, touch each other’s wounds, or ‘borrow’ other people’s toothbrushes.1

What does the vaccine protect babies from?

The vaccine protects babies from hepatitis B, a virus that mostly affects the liver. Hepatitis B often doesn’t make children sick when they first get it but it can cause serious liver disease, including cancer, later in life. You can read more about hepatitis B below:

Hepatitis B

Hepatitis B is a liver infection. Babies usually don’t look or feel sick when they first catch hepatitis B, but it can cause serious liver diseases, including liver cancer, later in life. It spreads from person to person through open wounds or sores. This can happen in households or even childcare settings. People infected with hepatitis B can pass on the disease without even knowing they have it.2

Learn more about hepatitis B and hepatitis B vaccination

How will the vaccine affect my baby?

Newborn babies don’t usually have any noticeable reaction to the hepatitis B vaccine after the sting of the needles has passed. New babies who get these injections don’t usually get the reactions (like fever or allergic reactions to something in the vaccines) that older babies can get.2

How can I make it easier for my baby?

No matter how gentle your midwife or doctor is, needles hurt a bit and most babies cry at least a little after they get a needle. The good news is that researchers are beginning to understand more about children’s pain and have found some things that will make needles feel less painful.

Breastfeeding relieves babies’ pain really well. You can ask your midwives to give your baby’s needles during a breastfeed.3,4 

Holding or cuddling babies, especially skin-to-skin, triggers the release of pain-relieving hormones. So if you aren’t able to breastfeed your baby straight after the birth, you can ask one of the midwives to give your baby’s needles while you or someone else holds her, preferably skin-to-skin (undressed) and held firmly chest-to-chest in an upright position.3,4

What if my baby is born early?

If your baby is born early (premature) it is even more important to protect them from hepatitis B because their immune systems aren’t as strong as they would be if they’d been born at term. Your baby’s vaccination might need to be delayed for a short time and they may need an extra dose. You can ask your baby’s medical team what they recommend.

Why is my baby getting two needles?

Most babies get two needles (injections) at birth. One is the hepatitis B vaccine and the other is a vitamin K injection. 

Vitamin K is not a vaccine. Babies usually get a vitamin K injection in their leg shortly after birth. Vitamin K helps prevent a condition called Vitamin K Deficiency Bleeding by helping the baby’s blood to clot. Vitamin K can also be given as drops in the mouth (oral vitamin K drops) over several days. Most health professionals recommend the vitamin K injection because it only needs to be given once.5

Learn more about about vitamin K and vitamin K deficiency bleeding disorder

Are there any rare side effects I need to know about?

Researchers haven’t found any serious side effects from the birth dose of the hepatitis B vaccine. Serious side effects do happen when older babies and children get vaccines that include hepatitis B but they are very rare.

If you are worried about your baby, you can get help from:
•    your midwife or doctor
•    your nearest emergency department
or by calling Health Direct on 1800 022 222.


When will my baby need more vaccinations?

When your baby is six weeks old, it is recommended they have three vaccines: a combined (or hexavalent) DTPa-Hib-IPV-Hepatitis B vaccine, a 13vPCV, and a rotavirus vaccine. Altogether, these vaccines protect children against eight diseases. Two of the vaccines are needles, usually given in the baby’s legs. The rotavirus vaccine is given as drops put into your baby’s mouth to swallow. It is important that babies and children get vaccinated on time to make sure they are protected as early as possible.

What if I still have questions?

If you still have some questions about vaccinations for your baby, write them down and make an appointment with your nurse, your doctor, or your health worker so you can ask them. 

  1. Australian Technical Advisory Group on Immunisation (ATAGI). Australian Immunisation Handbook, Australian Government Department of Health, Canberra, 2018,
  2. Lewis E, Shinefield HR, Woodruff BA, Black SB, Destefano F, Chen RT, et al. Safety of neonatal hepatitis B vaccine administration. Pediatric Infectious Disease Journal. 2001;20:1049- 54.
  3. Pain management strategies for childhood immunisation. In Handbook of Non-Drug Interventions Royal Australian College of General Practitioners: 2018. Accessed 16NOV18
  4. Taddio A, et al. Reducing pain during vaccine injections: clinical practice guideline. Canadian Medical Association Journal 2015;187:975-982. 
  5. Joint statement and recommendations on vitamin K administration to newborn infants to prevent vitamin K deficiency bleeding in infancy. Commonwealth of Australia. 2010. Accessed 21NOV2018