In U.S. hospitals, newborns typically receive two shots: a vitamin K injection and the first hepatitis B vaccine.
First hours with a baby come with a few quick medical steps. Families often ask how many shots a newborn gets before leaving the hospital. The short answer for routine care is two. One is the vitamin K shot that prevents dangerous bleeding. The other is the first dose of the hepatitis B vaccine.
Alongside those injections, nurses handle several standard tasks that do not involve needles. Eye ointment goes on the lids, a tiny heel prick collects blood for state screening, a hearing check runs with sensors, and a pulse oximetry check looks for heart defects. Only the vitamin K dose and the birth dose of hepatitis B are shots.
| Newborn Care Item | Why It’s Done | How It’s Given |
|---|---|---|
| Vitamin K injection | Prevents vitamin K deficiency bleeding | One intramuscular shot in the thigh |
| Hepatitis B vaccine (birth dose) | Protects against hepatitis B virus | One intramuscular shot in the thigh |
| Erythromycin eye ointment | Lowers risk of newborn eye infection | Ointment placed on the eyelids |
| Newborn blood spot screen | Checks for rare conditions | Heel prick with a few drops on a card |
| Hearing screen | Checks early hearing | Small sensors in the ear canal |
| CCHD pulse oximetry | Screens for critical heart defects | Light sensor on hand and foot |
How Many Newborn Shots In The USA Are Routine?
In a standard birth stay, healthy babies get two injections. The first is the vitamin K shot. The second is the hepatitis B vaccine birth dose. Both are given in the thigh. Timing is quick and usually finished within the first day.
Some babies need an extra injection based on risk for hepatitis B. If the birth parent has hepatitis B, or if test results are missing at delivery, clinicians also give hepatitis B immune globulin. That dose is a separate shot that helps block the virus while the vaccine series builds longer lasting protection. Most babies do not need the immune globulin dose.
Vitamin K Shot: What It Does And When It’s Given
Newborns start life with low vitamin K levels, which raises the risk of serious bleeding in the brain or gut. A single injection fixes that gap fast. Hospitals give 1 milligram into a thigh muscle, usually within six hours after birth. The dose can wait until after the first feed and skin to skin time and still meet the window.
Dose And Timing
The shot works well. Babies who skip it face far higher odds of bleeding in the first weeks. See the CDC overview on vitamin K for newborns for background.
Hepatitis B Vaccine At Birth: Why It Starts Day One
The hepatitis B virus can pass during birth or through contact with blood or body fluids. Infection early in life often becomes chronic. That can lead to cirrhosis or liver cancer years later. Giving the first vaccine dose soon after delivery cuts that chain of transmission.
Current CDC guidance calls for a universal birth dose for medically stable infants, with later doses at one to two months and again at six to eighteen months. Those steps guard babies even when a parent’s infection is missed on labs drawn late in pregnancy. See the CDC page that states a birth dose for all infants today.
Babies at higher risk get extra protection. If the birth parent is infected, staff add hepatitis B immune globulin in a separate limb within twelve hours. Preterm infants under two thousand grams follow special timing that the schedule notes detail. Your care team will map that plan before discharge.
Needles Versus Other Newborn Care
Families sometimes count a heel stick as a shot. It is not. A lancet makes a tiny puncture on the heel for a few drops of blood. That sample goes to the state lab to check many rare conditions. Looking early helps teams start treatment fast when needed.
The eye ointment is a thin ribbon applied to both lids. It helps stop eye infections passed during delivery. A quick hearing check comes next. Soft sensors play clicks and measure the ear’s response while the baby naps. A pulse oximetry reading on the hand and foot helps find serious heart defects before symptoms start.
First Year Snapshot: When More Vaccines Happen
The birth day kicks off a series that continues through the first months. Vaccine names vary by brand, and combination shots lower needle counts at some visits. Your clinic will match products that fit your baby’s chart and any state programs.
The CDC’s child and adolescent schedule lays out timing in a simple grid and notes special cases, including care for preterm infants and babies with liver risk. Your team uses that chart at each visit to plan the next steps.
What To Expect During Each Injection
A nurse or doctor cleans the site on the thigh, then uses a small needle for the dose. The shot takes seconds. Many babies cry for a short time. Skin to skin, feeding, and gentle rocking settle most babies fast.
After a hepatitis B dose, the site may look a bit red or feel firm. That fades in a day or two. Fever at this age is rare after the birth dose. If your baby feels warm, take a rectal temperature and call your care team for guidance.
Comfort Tips For Those First Shots
A calm setup helps. Hold the baby skin to skin when the nurse is ready. Feeding during the shot lowers pain cues. Many nurseries use oral sucrose for short procedures of this kind. Ask what your hospital offers and what you prefer.
Keep the bandage on for a short time, then remove it. A warm cuddle eases fussing. Mild redness at the site is common. Call your care team if swelling spreads, the area looks streaky, or the baby seems unwell.
Why Counts Vary In Special Situations
Twins, preterm births, and transfers add small twists. A baby who weighs under two thousand grams may need an altered hepatitis B plan. An exposed infant gets immune globulin at birth, which is a third injection on day one. A baby who needs NICU care still gets vitamin K and a vaccine dose once stable unless a doctor advises a short delay for a clear reason.
Families sometimes choose to delay parts of newborn care. Hospitals document those choices with a form, then re offer during the stay. If you decline a shot, ask how to schedule it later and what signs to watch for at home. Keep paperwork from the hospital so your clinic can update records.
Rules, Consent, And Hospital Workflow
States set requirements for eye ointment and newborn screening. Shots follow national guidance, which hospitals standardize in order sets. Staff will ask for consent and answer questions before each step. If you want time with the baby first, share that plan on arrival so nurses can bundle care around feeding and bonding.
In rare cases a baby may need extra monitoring before injections. If a dose shifts by a few hours, teams note the time and complete the plan as soon as the baby is ready. Before discharge, a nurse reviews what was given and what comes next.
Staying On Track After Discharge
Set the first clinic visit before you leave the hospital. The team will review screening results, check weight, and plan the next vaccine dates. Bring the immunization card the nursery started so records stay aligned at each stop. Keep the discharge summary handy and bring it to appointments later.
Many states text reminders for well baby visits and vaccines. Enroll if your hospital or clinic offers that service. If you move or change clinics, ask for a printed record and a digital copy for your files.
At A Glance: First Year Vaccine Timeline
| Age | Vaccines Commonly Given | Notes |
|---|---|---|
| Birth | Hepatitis B #1; vitamin K shot | HBIG added for exposed infants |
| 1–2 months | Hepatitis B #2 | Some clinics pair with a checkup |
| 2 months | DTaP, Hib, IPV, PCV, Rotavirus | Rotavirus is oral, not a shot |
| 4 months | DTaP, Hib, IPV, PCV, Rotavirus | Second round |
| 6 months | DTaP, Hib, IPV, PCV; Hep B #3 | Flu starts at 6 months in season |
| 12 months | MMR, Varicella, Hep A #1, PCV booster | Exact timing can vary |
Safety Notes And Rare Reactions
The vitamin K injection is a vitamin dose, not a vaccine. The hepatitis B shot has an excellent safety record built across many years and many millions of births. Mild fussiness or a small sore spot can follow either injection and fades quickly. If your baby looks pale or hives appear, alert staff.
Fever in a young infant needs prompt attention. Call your clinic if the reading reaches one hundred point four degrees Fahrenheit or higher. Go to urgent care or an emergency department if your baby is hard to wake, has trouble breathing, or will not feed after repeated tries.
Bottom Line On Newborn Shots
At birth, routine care in the USA includes two injections. The vitamin K shot prevents dangerous bleeding. The first hepatitis B vaccine dose starts early protection. Other newborn tasks run without needles. Extra injections happen only when risk for hepatitis B is present or a clinical need arises.
For reference, the CDC explains the universal birth dose for hepatitis B on its perinatal care page and publishes the child and adolescent schedule clinics use to plan doses. Ask your hospital or clinic for a copy of the vaccine record started at birth.