Hepatitis B: What Parents Should Know

March 02, 2026

Hepatitis B is a virus that affects the liver and can have serious consequences for newborns, infants and young children. For more than 30 years the U.S. Centers for Disease Control and Prevention (CDC) recommended all babies receive the hepatitis B vaccine at birth, regardless of their risk. However, the CDC’s vaccine advisory committee recently overturned this recommendation, saying the decision should be left between parents and their healthcare providers.

Still, most pediatric health experts continue to recommend the hepatitis B vaccine to prevent a chronic infection that can lead to liver disease, cancer and even death, says University Hospitals pediatric infectious disease specialist Amy Edwards, MD.

What Is Hepatitis B?

The hepatitis B virus causes inflammation of the liver and can cause both acute and chronic infections. Many people will not experience any symptoms when newly infected. If someone develops acute hepatitis soon after infection, they may experience symptoms such as:

Jaundice (yellowing of the skin and eyes)
Dark urine
Fatigue
Nausea, vomiting or abdominal pain

Treatment for acute hepatitis B focuses on managing symptoms. Most people with an acute infection will make a full recovery without lasting effects.

Some people whose immune systems can’t fight off the virus may develop a chronic hepatitis B infection. A chronic infection can increase a person’s chance of developing complications such as liver failure, cirrhosis and liver cancer. Chronic hepatitis B can be treated with antiviral medications to improve long-term survival. These medications often need to be taken indefinitely to prevent the progression of complications.

How Is Hepatitis B Spread?

Hepatitis B is transmitted through body fluids such as blood, saliva, vaginal fluids and semen. It can spread through sexual contact, shared needles and casual contact with body fluids.

In newborns, the virus is most often passed from mother to child during childbirth. However, an infant or child can also become infected through contact with blood from another individual with hepatitis B. The highly infectious virus can live on surfaces for up to seven days, so it may spread through household items containing trace amounts of blood, such as razors, nail clippers, towels and toothbrushes.

A Serious Risk for Infants and Children

A child infected by hepatitis B at birth or in infancy has over a 90 percent chance of developing a chronic infection and children up to age 5 have a 50 percent chance. By comparison, only 5 to10 percent of adults develop a chronic infection after exposure. About 25 percent of children with chronic hepatitis B may die from related complications when they are adults. These complications may not show up for years or decades after being infected with the virus.

Why Vaccination Matters

Even if a mother tests negative for hepatitis B before delivery, a child can still be at risk of being infected by other people they encounter. The CDC estimates there are about 640,000 people living with chronic hepatitis B in the U.S. and about half of them don’t know they have it. This can make it harder to know whether a child is at a higher risk of being exposed to the virus.

“Routine vaccination takes the guesswork out of risk assessment and helps ensure that every baby is protected,” says Dr. Edwards.

The hepatitis B vaccine is nearly 100 percent effective at preventing hepatitis B infection and numerous studies have shown that the hepatitis B vaccine is very safe. Severe allergic reactions are extremely rare and the vaccine presents no long-term safety issues. No link has been found between the vaccine and autism or other developmental issues.

What Experts Recommend

The American Academy of Pediatrics (AAP) recommends universal hepatitis B vaccination for all infants. The first dose should be given within 24 hours of birth, followed by two additional doses at least four weeks apart. This three-dose series is believed to provide at least 20 years of protection, but likely will provide lifelong protection for the child.

Low Rates of Childhood Infection Thanks to Vaccine Success

While infants and children are among the most vulnerable to this disease, new infection rates are now extremely low due to the success of the hepatitis B vaccination program, says Dr. Edwards.

After the introduction of routine vaccination at birth, hepatitis B infections in infants and children have decreased by 99 percent, and overall cases have dropped dramatically. The vaccine protects both children and adults from serious complications of chronic hepatitis B, lowering their risk for liver cancer and other diseases.

“Even low-risk newborns can benefit from this simple, safe vaccine series that can provide decades of protection from a potentially deadly infection,” says Dr. Edwards.