Healthy newborns in the United States typically receive one vaccine at birth—the first hepatitis B shot within 24 hours.
Newborn Shots At Birth In The USA — What’s Routine?
Parents want a clear answer on day one. In most hospitals, a full-term baby gets a single vaccine right after delivery: hepatitis B. It’s the opening dose in a three-shot series that guards against a stubborn liver infection. Staff give it in the thigh, and it pairs well with skin-to-skin and early feeding now.
Not every needle on the birthday is a vaccine. New babies often get a vitamin K shot to prevent bleeding and an antibiotic eye ointment to prevent eye infection. Those are care standards, not immunizations. Hearing checks and the tiny heel prick for state metabolic screening also join the first-day list.
What A Newborn Might Receive On Day One
| Item | What It Does | Is It A Vaccine? |
|---|---|---|
| Hepatitis B shot (birth dose) | Starts protection against hepatitis B; given within 24 hours | Yes |
| Vitamin K injection | Prevents dangerous bleeding in the first weeks | No |
| Erythromycin eye ointment | Lowers risk of newborn eye infection | No |
| HBIG for at-risk infants | Immediate antibodies for babies exposed to hepatitis B at delivery | No (immune globulin) |
| RSV antibody (nirsevimab) | Seasonal protection against severe RSV illness | No (monoclonal) |
| Newborn metabolic screen | Detects rare conditions from a heel-prick sample | No |
| Hearing screen | Checks hearing before discharge | No |
For the birth vaccine, the national guidance is straightforward: give a dose of hepatitis B to every infant within 24 hours of life. That approach protects babies even when a parent’s infection wasn’t known before labor or a test missed a very recent infection.
See the official wording from the CDC perinatal page, which also explains timing and special cases. If a baby is born during RSV season and didn’t get protection through pregnancy, hospitals can offer an RSV antibody shot before discharge.
So, How Many Vaccines At Birth In The U.S.?
For a healthy term baby born in the U.S. right now, the count is one: the hepatitis B birth dose. Preterm and higher-risk scenarios can add medicines, but those aren’t vaccines. The next routine vaccines arrive at the two-month visit.
Why The Hepatitis B Shot Starts On Day One
Hepatitis B spreads through blood and body fluids and can pass during delivery. When a baby gets infected at birth, long-term infection is common and can lead to liver disease. Starting the series in the first day blocks that path for almost every baby and buys time while test results are confirmed.
Hospitals use single-antigen hepatitis B for the newborn dose. Later doses can be single-antigen or a combo product during infancy. Babies born before 2,000 grams sometimes follow a slightly different schedule if the birth parent tests positive, and the team documents that plan before discharge.
Close Variations Of The Question You Might Hear
How many vaccines do babies get right after birth in the U.S.? Still one—hepatitis B—unless a special risk calls for extra medicines. Do hospitals give BCG in America? No. The tuberculosis vaccine isn’t used in routine U.S. newborn care.
Is the RSV shot a vaccine? It’s a single-dose antibody that acts like armor for RSV season. It doesn’t teach the immune system the way a vaccine does, but it lowers the chance of severe RSV disease for months, and many nurseries give it before discharge when eligible.
When Newborns Need Extra Protection Against Hepatitis B
Some infants face higher exposure at delivery. When a birth parent’s test is positive, the baby gets two injections within 12 hours: the hepatitis B vaccine and HBIG, which supplies immediate antibodies. When the parent’s status is unknown at delivery, staff give the birth vaccine right away and follow up with HBIG if testing later shows infection. This fast start prevents nearly all transmission.
Feeding, Soothing, And The First Shot
Most units give the dose in the first day, often while the baby is on a parent’s chest. Swaddling, breastfeeding, a pacifier, or sugar water can ease fussing. A warm thigh helps, and a firm cuddle afterward calms most babies in seconds.
Pain at the site is mild and brief. Low-grade fever is uncommon at birth doses. Staff watch for allergic reactions, which are rare. Parents get the vaccine lot number on the discharge paperwork so the pediatric office can complete the series on schedule.
RSV Season: When A Newborn Might Get An Antibody Before Going Home
RSV fills children’s hospitals every winter. Two infant antibody products are available this season, and nurseries can give them to eligible babies before discharge when the calendar lines up. The goal is simple: cover infants for their first months at home when RSV hits the hardest. The pediatrician continues the plan after discharge.
The CDC clinician page explains which infants qualify and how this fits with maternal vaccination during pregnancy. If you’re still in the hospital during the season, ask whether your baby meets criteria and when the shot would be given.
Safety Snapshot
Hepatitis B: What To Expect
Local redness or swelling can happen and fades quickly. Serious reactions are rare, and staff report and study any event. The benefits of preventing lifelong infection far outweigh short-lived soreness.
RSV Antibody: What To Expect
The most common issue is mild injection-site irritation. Nurseries screen for rare conditions that would delay or avoid the shot and share that plan with the pediatrician.
Your Hospital Game Plan
Ask labor and nursery teams how they handle the first-day tasks. Clarify where and when the hepatitis B dose is given, how you’ll receive paperwork, and how the next shots will be scheduled. If your baby may qualify for an RSV antibody, ask whether the hospital gives it before discharge during the season.
If your pregnancy records show hepatitis B surface antigen testing, bring a copy. If not, expect a rapid test during labor. Hospitals follow strict cold-chain rules, so shots are stored and handled at safe temperatures from pharmacy to bedside. Most hospitals give the shot during the first shift after birth.
Hepatitis B At Birth: Common Scenarios
| Scenario | In First 12–24 Hours | Next Steps |
|---|---|---|
| Birth parent HBsAg positive | HepB vaccine + HBIG in separate sites ≤12 hours | Complete series; check serology later |
| Status unknown at delivery | Give HepB immediately; add HBIG if parent later tests positive | Finish series per schedule |
| Birth parent HBsAg negative | Give HepB within 24 hours | Return for doses at 1–2 months and 6–18 months |
| Preterm <2,000 g, parent negative | Birth dose may not count toward series | Schedule extra doses as directed |
What Happens After Discharge
The pediatric visit in the first days checks weight, feeding, jaundice, and paperwork. That visit is the time to book the two-month appointment, when babies receive the first larger set of vaccines. Keeping those dates tight keeps the whole series on track.
Families who choose a birth center or home setting should talk in advance about hepatitis B access on day one and how records will reach the pediatric practice. Mobile services or a quick clinic visit can handle the shot if it isn’t available on site.
Fast Facts At A Glance
- U.S. newborns typically get one vaccine at birth: hepatitis B.
- Vitamin K and eye ointment are standard care but not vaccines.
- Babies at risk for hepatitis B exposure get HBIG with the vaccine.
- During RSV season, eligible infants can receive an antibody before discharge.
- The next vaccine visit comes at two months.
Plain Answer For New Parents
If you’re counting vaccines on the birthday in the United States, it’s one. That single hepatitis B dose starts lifelong protection and sets the stage for the rest of the schedule. Your nurse can give it during skin-to-skin or a calm cuddle, and the moment takes less than a minute. Everything else your baby gets on day one sits in the care bucket, not the vaccine list.
Preterm And NICU Babies: How Birth Shots Work
Early arrivals often start life in a warmer or NICU bay, and the hepatitis B plan still starts promptly. If the birth parent tests positive, staff give the vaccine and HBIG within 12 hours, even for very small infants. When parents test negative and a baby weighs under 2,000 grams, the dose may be given now for short-term protection, then repeated later because that first dose might not count toward the series. During RSV season, eligible NICU patients can receive an antibody a day or two before discharge.
Paperwork, Consent, And Keeping Records Straight
Hospitals use consent forms for newborn medicines and vaccines. After the shot, the nurse records the lot number, site, and time. Copies go home with you and into the electronic chart so the pediatric clinic can finish the series without guesswork. If English isn’t your first language, ask for translated forms or an interpreter so details match what you want for your baby.
If You Choose To Delay The Birth Dose
Some parents prefer to start at the first pediatric visit. That choice leaves a window if a test missed a very recent infection or if the baby needs an urgent procedure before discharge. If you wait, set a firm date with the clinic and keep lab results handy. The catch-up schedule works, but day-one dosing closes gaps and keeps the rest of the plan simple.