A new national study led by Denver Health pediatrician Josh Williams, MD, published on Apr. 24 in the Journal of the American Medical Association Network Open, finds that giving newborns a hepatitis B vaccine is strongly linked to higher and more equitable completion of the full three-dose series.
The findings are important as public confusion about childhood vaccine schedules and hesitancy continue to grow. Hepatitis B can cause chronic infection if contracted early in life, which increases risks for cirrhosis and liver cancer later on. The American Academy of Pediatrics recommends vaccinating all infants within 24 hours of birth.
Williams said, “In this study, Hepatitis B vaccination at birth set all children up for success in completing the three-dose vaccine series on time, regardless of their race, ethnicity or language.” He added: “Ensuring newborns receive the birth dose is one of the most effective ways we can prevent disease and reduce health disparities from day one.”
Researchers analyzed data from over 1.1 million children born between 2014 and 2023 across nine sites participating in the Vaccine Safety Datalink (VSD), which covers about four percent of the U.S. population. The cohort was diverse in terms of race, ethnicity and language; it also included a new racial category—Middle Eastern or North African—in line with updated federal guidance.
Results showed that overall, just over 81 percent received a hepatitis B dose at birth while nearly 87 percent were fully vaccinated by age eighteen months. Of those who got the first dose at birth, almost all (97.6 percent) completed all three doses within eighteen months—across every racial and language group studied.
For those who missed getting vaccinated at birth (18.8 percent), completion rates dropped significantly—from more than seventy-three percent among babies born in 2014 to just over fifty-five percent among those born in 2023. Children identified as Asian or Middle Eastern/North African—and families speaking Chinese or Vietnamese—had higher completion rates despite missing a birth dose; White children and English-speaking households had lower coverage when missing this early shot.
The study highlights how attention to race, ethnicity and preferred language matters when researching biomedical outcomes—and points to administering hepatitis B vaccines at birth as an important way to improve health equity nationwide.
