One vaccine at birth: the hepatitis B (HepB) shot within 12–24 hours, with more routine infant vaccines starting at age 2 months in the U.S.
The week a baby arrives brings many decisions. One is simple: in the U.S., a healthy newborn typically gets one vaccine before leaving the hospital.
That shot is hepatitis B, given fast after delivery to block a virus that can quietly harm the liver.
A few other items happen the same day, like vitamin K and eye ointment, but those are medicines, not vaccines.
This guide explains timing, special cases, and what comes next, with a quick hospital table and a first-year snapshot. Simple and clear.
Newborn Vaccinations In The USA: What’s Given At Birth
The standard newborn vaccine in the U.S. is hepatitis B, usually given in the first day of life.
That timing protects babies when a parent’s test is pending or an infection was missed.
Hepatitis B immune globulin may also be given when the birth parent carries the virus. It partners with the vaccine but is not a vaccine.
Other routine newborn items can be confused with vaccines because they involve needles or drops. Vitamin K prevents dangerous bleeding; erythromycin eye ointment lowers the risk of certain infections; a heel-prick sample screens for rare disorders.
These are standard hospital tasks, but they do not teach the immune system to fight germs, so they are not counted as vaccines.
| Item | What It Does | Given At Birth? |
|---|---|---|
| Hepatitis B vaccine | Prevents HBV and later liver disease | Yes — 12–24 hours |
| HBIG | Antibodies for babies of HBV-positive parents | Only if the birth parent has HBV |
| RSV long-acting antibody | Seasonal RSV protection (passive) | If born in season or if advised |
| Vitamin K injection | Prevents bleeding in early weeks | Yes |
| Erythromycin eye ointment | Prevents eye infection after delivery | Yes (state rules vary) |
| Heel stick screen | Checks for rare disorders | Yes |
Why The Hepatitis B Shot Happens So Early
Hepatitis B spreads through blood and body fluids. Adults often clear the virus,
but infants who catch it at birth face a high chance of long-term infection that can damage the liver years later.
A dose at delivery slashes that risk and has helped drive down new infections nationwide.
Timing: 12–24 Hours Is The Window
Hospitals give the vaccine within 24 hours for medically stable newborns.
When the birth parent has hepatitis B, the baby should get two items quickly: the vaccine and a dose of hepatitis B immune globulin, ideally within 12 hours.
The vaccine starts the baby’s defense; the immune globulin adds temporary protection while that response builds.
What About RSV Protection Right After Birth?
RSV is a lung virus that sends many infants to the hospital in winter.
Protection for newborns uses two tools: a vaccine during pregnancy and a long-acting antibody for the baby.
The antibody is a single shot when the parent did not receive the RSV vaccine or when extra protection is advised. It is not a vaccine.
Because it is passive protection, that RSV antibody is not counted when people ask how many vaccines a newborn gets.
Still, it matters for families with fall or winter births.
Babies born during RSV season can receive the antibody within the first week of life, often before discharge, based on supply and local policy.
How Many Shots Do Babies Get At The First Checkups?
Newborns start with one vaccine, then the first big set arrives at the 2-month visit.
That visit usually includes shots that guard against whooping cough, tetanus, diphtheria, polio, Hib, and pneumococcal disease, plus oral rotavirus drops.
Some offices use combination products to cut needle sticks. Clinics follow the CDC child and adolescent schedule and AAP guidance.
Dose Count Vs. Disease Count
Parents often track two numbers: how many needle sticks and how many diseases covered.
Combination vaccines can bundle ingredients safely, so a baby may receive fewer injections while still gaining broad coverage.
Clinics follow the CDC and AAP schedules, which list the timing and options for each age.
Preemies, NICU Stays, And Birth Weight Rules
Birth weight and medical stability guide the birth-dose plan.
Babies who weigh two kilograms or more usually get hepatitis B within 24 hours.
Babies under that weight may receive the shot at one month if the birth parent’s hepatitis B test is negative.
If the birth parent has hepatitis B, the small baby still gets both the vaccine and immune globulin within 12 hours, with later doses adjusted by the care team.
Pain, Side Effects, And Safety
Most newborns tolerate the hepatitis B shot well.
Brief soreness at the site and a day of fussiness are the usual notes in the chart.
Serious reactions are rare.
The vaccine has been watched for decades with many safety checks, and the benefits in preventing chronic hepatitis B are large compared with the short-lived discomfort.
Comfort Tips That Help
Skin-to-skin holding, feeding during or right after the shot, and a calm room can settle a baby fast.
Ask staff to review the plan before the injection so you can help right away.
If your baby is in the NICU, the team will time the shot around other care so the day still feels steady.
How Parents Can Prep Before Delivery
During the third trimester, make sure your hepatitis B surface antigen test is on file and up to date.
Bring a copy of your results to the hospital just in case.
Ask your hospital where the birth-dose consent is signed and how your baby’s vaccine record will be shared with your pediatric clinic.
If you are due near the fall or winter months, ask your prenatal team about the RSV vaccine during pregnancy and newborn RSV antibodies after birth.
First-Year Vaccine Snapshot So You Can Plan Ahead
Knowing what comes next helps visits run smoothly.
The next months bring steady checkups where protection grows layer by layer.
Use the table below as a quick reference.
Your clinician may adjust products based on supply and any catch-up needs, but timing stays close to this outline.
How Clinics Reduce Needle Sticks
Clinics use combo shots that pair DTaP with polio and Hib or bundle DTaP with HepB.
That trims needle sticks and meets the schedule.
If combos are out, single shots work as well.
| Age | Diseases Covered | Typical Doses At Visit |
|---|---|---|
| Birth | HepB | 1 injection |
| 2 months | DTaP, Hib, IPV, PCV, Rotavirus | 3–5 shots + oral |
| 4 months | DTaP, Hib, IPV, PCV, Rotavirus | 3–5 shots + oral |
| 6 months | DTaP, IPV, PCV; Hib/Rotavirus per brand; flu starts; COVID-19 at 6 months | 2–4 shots; oral if needed |
| 9 months | Often none; catch-up only | Varies |
| 12 months | MMR, Varicella, HepA; PCV/Hib finish per brand | 2–4 shots |
Answering the headline: one vaccine at birth for hepatitis B, with an added immune globulin dose for some babies when a parent carries the virus.
RSV protection may be offered as an antibody during the cold season and does not count as a vaccine.
Keep the record from the hospital and bring it to the first visit.
What Counts As The Newborn Period For Vaccines
Newborn means the first 28 days of life.
Within that window the only routine vaccine is hepatitis B, with the first dose at birth.
The next doses come at one to two months and again between six and eighteen months.
If a dose is late, the series does not restart; the clinic gives the next dose at the next visit.
Questions Parents Commonly Ask In The Hospital
Many parents ask whether the shot can be given during skin-to-skin.
Yes—nurses can place the baby on your chest and reach the thigh without breaking contact.
Parents also ask about rooming-in versus the nursery.
Either location works; the key is a calm setup and quick cuddling after the injection.
Some families ask about delaying.
The birth dose is timed to block exposures no one plans for, so clinics advise giving it on time.
If a birth parent’s test later shows hepatitis B, a delay could leave a baby unprotected during the most fragile days.
When a baby is not yet stable, the team gives the shot as soon as it is safe.
Feeding method does not change the plan.
Breastfeeding, chest feeding, or formula feeding—all babies benefit from the birth dose.
The vaccine does not contain live virus and does not affect milk or feeding routines.
Your baby can feed right after the shot, which often settles both baby and parent.
Home Births, Birth Centers, And Births Outside Hospitals
If you plan a home birth or a freestanding birth center, ask about hepatitis B storage, consent, and who enters the dose in the registry.
Some midwife teams give the shot on site and file the record; others arrange a quick clinic visit in the first day or two.
If a transfer to a hospital is needed, the receiving team can give the dose and handle paperwork.
Documentation That Follows Your Baby
Hospitals and clinics report vaccines to state or city registries.
This helps your pediatric office confirm dates and prevents duplicate shots.
Before discharge, ask for a printed record and a digital portal copy.
Bring that copy to the first visit, and snap a photo for your own files.
Set a reminder for the 2-month visit so the next set of protection arrives on time.