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1. Hepatitis B and BCG vaccination
birth dose (Maternity ward)
Appreviations:
• HepB : Hepatitis B
• BCG: Bacile Calmette Guerin
• HIV: Human Immunodeficiency Virus.
• NIP: National Immunization Program

2. Hepatitis B vaccine
Introduction
 Hepatitis B (Hep B) is a viral infection in the
blood that cause liver problems including liver
cancer.
 If a mother is infected with Hep B, the virus
can be transmitted to the baby during birth.
 90% of baby infected with Hep b around the
time of birth will carry the infection for life
(chronic).
 25% of babies who develop chronic infection
will die of liver failure or liver cancer later in
life.
 Because of don’t feel sick, most people do
not know they have the infection.
3/30/2016 SKMH Maternity 2

3. Hep B vaccine- con’t
 Prevention of perinatal HBV transmission
In order to prevent HBV transmission from
mother to infant, the first dose of HB
vaccine needs to be given as soon as
possible after birth (preferably within 24
hours). (WHO)
 The NIP policy recommends Hep B birth
vaccine is given within 24 hrs after birth,
as this is when it is most effective. It can
be given up to 7 days where this can not
be achieved.
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4. Hep B vaccine- con’t
Presentation
 Hepatitis B vaccines are available in liquid single-
dose glass vials.
Injection equipment
 0.5 ml auto-disable (AD) syringes are
recommended.
 If AD syringes are not available, standard
disposable syringes (1 ml or 2 ml with 22/23
gauge needle is recommended) must be used
ONCE ONLY.
Dosage
 The standard paediatric dose is 0.5 ml.
Route
 Intramuscular (IM) injection into the right thigh.
3/30/2016 SKMH Maternity 4

5. Hep B vaccine- con’t
All the baby should have Hep B vaccine.
◦ Low birth weight baby
◦ Premature baby
◦ Jaundice (yellow)
◦ And HIV mother should still given Hep B vaccine.
3/30/2016 SKMH Maternity 5

6. Hep B vaccine- con’t
 Minimal side effect:
◦ Local pain (3-29/100)
◦ Myalgia
◦ Transient fever (mostly within 24hrs) (1-
6/100)
◦ Swelling (3/100)
◦ Erythema (3/100)
◦ Headache (3/100)
 Severe reaction: anaphylaxis
(1.1/1000000)
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7. 3/30/2016 SKMH Maternity 7
Hepatitis B Injection

8. 3/30/2016 SKMH Maternity 8

9. BCG vaccine
Introduction
 BCG (Bacille Calmette Guerin) called Mycobacterium
bovis which is closely related to Mycobacterium
tuberculosis, the agent responsible for tuberculosis. It is
prevent children getting more severe forms of TB,
particularly TB meningitis.
 It is freeze-dried and need to be mixed with the correct
diluent from the same manufacturer before
administration
Dose:
 a vial with 20doses, dose for new born is 0.05ml.
Route:
 ID into the R) upper arm.
 BCG vaccine vials must be discarded 6hrs after mixing.
 BCG can give up to baby 1 year old.3/30/2016 SKMH Maternity 9

10. BCG vaccination:
 Mild side effect
◦ Papule may be red, tender and
indurated (2-4wks).
◦ The papule commences two or more
weeks after vaccination and then may
progress to become ulcerated healing
after 2-5 months leaving a superficial
scar.
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11. BCG vaccination (con’t)
 Severe adverse effect (rarely)
◦ Local abscess
◦ Keloid
◦ Lymphadenitis
◦ Suppuration (onset 2-6 months)- 1per 1000-
100000
◦ Systemic (1-12 months onset time)
◦ Cutaneous skin lesions
◦ Osteitis (1/3333-100000000)
◦ Disseminated BCG
◦ Immune Reconstitution Syndrome: collection
of inflammatory disorders
3/30/2016 SKMH Maternity 11

12. BCG and Hep B vaccine
Contraindications:
Absolute contraindications
 Anaphylaxis after a previous dose.
 Immunodeficiency: do not give BCG
vaccine to an infant who is known to
be infected with HIV, even if they have
no symptoms. Other vaccine can be
given.
Relative contraindications
 Temperature > 38.5. children with
minor cough and colds can safely3/30/2016 SKMH Maternity 12

13. Vaccine vial monitors (VVMs)
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14. BCG injection site
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