A term neonate born to a hepatitis B surface antigen (HBsAg)-positive mother is ready for discharge. The mother is also HBeAg-positive. What is the correct prophylaxis protocol per guidelines?

• A Hepatitis B vaccine within 12 hours of birth only
• B HBIG 0.5 mL IM only (vaccine deferred to 6 weeks)
• C Both HBIG and vaccine within 7 days of birth
• D HBIG 0.5 mL IM + hepatitis B vaccine at different sites within 12 hours of birth, followed by vaccine at 1 and 6 months ✓

Explanation

For neonates born to HBsAg-positive mothers (especially HBeAg-positive, implying high viral load and greater transmission risk), the perinatal transmission prevention protocol requires BOTH HBIG 0.5 mL IM AND hepatitis B vaccine at different injection sites within 12 hours of birth. This combination reduces perinatal transmission by >90%. Vaccine alone is ~70% protective; vaccine with HBIG is significantly more effective when mother is HBeAg-positive. Subsequent vaccine doses at 1 month and 6 months complete the series. Testing for HBsAg and anti-HBs at 9-12 months verifies success. Delaying either HBIG or vaccine beyond 24 hours significantly reduces efficacy.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.