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Many wonder why it makes sense to vaccinate a newborn for a sexually transmitted disease. Ask a doctor, and they will likely argue that vaccination can protect the child from disease with mothers testing positive for hepatitis B. But is this really the case?
CDC guidelines recommend that mothers should be tested for hepatitis B antigen in early pregnancy, and that infants born to mothers testing positive should receive vaccination.

cdc.gov/mmwr/preview/m…
This raises a serious issue because mothers suffering from acute infection will develop antibodies that are transferred across the placenta to the fetus. A mother testing positive in early pregnancy can develop antibodies prior to giving birth.

publichealthlab.ca/reportingname/…
These maternal antibodies can actually protect the newborn, but also suppress the immune response to vaccination. A 2016 study states that maternal antibodies are a double edged sword, because they inhibit the effect of vaccination.
The authors conclude that vaccination may not be the optimal choice for infants of mothers testing positive for hepatitis B.

ncbi.nlm.nih.gov/pubmed/27469237
With this being said, one has to wonder what is the justification for administering the hepatitis B vaccine to newborns. Clues can be found in another 2018 study focusing on the rationale behind the vaccine.
This is an interesting study that recognizes the newborn immune system as distinct and unable to respond to vaccination like adults.
However, the authors attempt to justify newborn vaccination with verbiage about high-population penetration at birth is a reliable point of healthcare contact, offering possible protection.

ncbi.nlm.nih.gov/pubmed/29670610
Finally, a 2013 study looking at immunological mechanisms of hepatitis B in newborns, mentions that countries implementing vaccination programs do not benefit from a decrease in disease prevalence.
The author admits this may be due to inefficacy of the immunization program itself.

ncbi.nlm.nih.gov/pubmed/24434322
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