Birth PlanFor us · hospital referenceAll sections

Section 02

Birth

Newborn shots and vaccines in Florida — what to expect, what we accept, and what to confirm.

Tasks

  • Research all possible vaccines and shots that may or may not be offered to the newborn in the state of FL
  • Decide Hep B birth dose (the actual vaccine; separate from HBIG)
  • Decide RSV antibody (nirsevimab / clesrovimab) if born in local season and mom did not get Abrysvo with adequate timing
  • Confirm hospital paperwork for eye-ointment decline (FL statute opt-out is written religious objection, not “mom screened negative”)

Preferences

  • Eye ointment (erythromycin): Decline — mother does not have gonorrhea. Hospital catch: Fla. Stat. § 383.04 requires prophylaxis within 1 hour unless parents file a written religious objection to drug use. A negative gonorrhea screen is not the statutory exception, and failing to give it is a 2nd-degree misdemeanor for the attendant (§ 383.07). Confirm the hospital will accept a decline in practice.
  • Vitamin K (phytonadione) IM: Tentatively accept — single IM dose is the preferred/gold-standard prophylaxis for VKDB in the US, UK, and many European countries (also Canada, Australia, New Zealand, Denmark); oral multi-dose regimens elsewhere are second-line alternatives. US caveat: there is no FDA-licensed oral infant product; most FL hospitals will not have oral vitamin K as a standing order.
  • HBIG: Decline unless a clear reason is provided (e.g. documented maternal HBsAg+ or other explained exposure risk)
  • Hep B birth dose: Undecided — see task above
  • RSV monoclonal antibody: Undecided — see task above

Newborn vaccines & shots in Florida (birth → discharge)

Cross-checked across three independent research passes plus a later gap pass (Fla. Stat. §§ 383.04 / 383.07, FAC 59A-11.016, CDC perinatal Hep B algorithms, CDC VariZIG, ACIP clesrovimab 2025, FL DOH RSV regions, FL school immunization rules, Mar 2026 injunction coverage, AAP vitamin K 2022).

This page is shots / prophylaxis / indicated medications, not pushing, assisted delivery, or C-section preferences. Immediate after-birth care and screening tests are in Newborn Care.

Expect to be offered (nearly all births)

Item Type Purpose Typical timing Florida status Can decline?
Erythromycin 0.5% eye ointment Topical prophylaxis (not a vaccine) Prevent gonococcal eye infection that can cause blindness. Does not reliably prevent chlamydial conjunctivitis (that’s prenatal screening / treatment). Within 1 hour of birth (FL law) Required by Fla. Stat. § 383.04 (AAP-recommended prophylactic; currently erythromycin). Penalty for the attendant: § 383.07 Yes — written religious objection only under the statute
Vitamin K (phytonadione) IM Injection (not a vaccine) Prevent vitamin K deficiency bleeding (VKDB) AAP: within 6 hours — 1 mg if >1500 g; 0.3–0.5 mg/kg if ≤1500 g. Birth centers: 0.5 mg within 24 hours Routine hospital care (AAP). Required in licensed birth centers (FAC 59A-11.016). No separate hospital statute found Yes in practice (refusal/waiver form). Birth centers: signed religious waiver process
Hepatitis B vaccine (birth dose) Vaccine (single-antigen only — not Pediarix / other combos) Prevent perinatal/early Hep B infection ≤12 h if mother HBsAg+ or unknown; otherwise often within 24 h / before discharge. Medically stable infants ≥2000 g: routine birth dose. <2000 g + HBsAg− mother: delay to discharge or age 1 month Not required by FL statute at birth. Still commonly offered as routine. Later 3-dose Hep B series is required for FL childcare and K–12 (DH 680) unless a DH 681 religious exemption is issued by a county health department. Skipping the birth dose does not skip the series — catch-up is allowed Yes (consent/refusal). Policy flux: CDC adopted shared decision-making for HBsAg− mothers (Dec 16, 2025), but a Mar 16, 2026 federal preliminary injunction stayed reconstituted-ACIP votes and effectively restores pre-change schedule guidance pending litigation/appeal. AAP has consistently favored universal birth dose. Confirm hospital standing orders.

Conditional / only if indicated

Item Type When it comes up Florida status Can decline?
HBIG (hepatitis B immune globulin) Passive antibody injection Always with Hep B vaccine, usually ≤12 h, if mother is HBsAg+. If maternal status is unknown: term/≥2000 g infants get vaccine ≤12 h and HBIG only if mom later tests positive (HBIG still useful up to 7 days). <2000 g + unknown: vaccine and HBIG ≤12 h Clinical / FL Perinatal Hep B program standard; not universal Consent applies; strongly indicated when exposure risk is real
RSV monoclonal antibody — nirsevimab (Beyfortus) or clesrovimab (Enflonsia) Long-acting antibody shot (not a traditional vaccine) Born during / entering first RSV season and mother did not get maternal Abrysvo ≥14 days before delivery (or status unknown). One product, not both; neither preferred over the other Recommended, not FL-mandated. FL seasons are regional: Northwest Oct–Apr; North Sep–Mar; Central Aug–Mar; Southwest Sep–Apr; Southeast often year-round (Jan–Dec). Stock/availability varies by hospital Yes
VariZIG (varicella-zoster immune globulin) Passive antibody injection Mother has chickenpox 5 days before through 2 days after delivery, or certain exposed premies. Give ASAP (ideally ≤96 h, up to 10 days). Not a routine offer CDC/AAP post-exposure prophylaxis; rare Consent applies; indicated when the exposure window is real
Penicillin G (regimen depends on evaluation — aqueous IV / procaine IM / sometimes benzathine IM) Antibiotic Congenital syphilis pathway based on maternal status / infant evaluation Treatment when indicated, not a routine offer Clinical decision; indicated cases are medical urgency
HIV antiretrovirals (usually oral, not a “shot”) Medication HIV-exposed newborn — start ASAP (often within 6 h) Clinical standard when indicated Consent applies; urgently indicated
Systemic gonorrhea treatment (typically ceftriaxone; not the eye ointment) Antibiotic Mother has untreated gonorrhea at delivery — in addition to eye prophylaxis Treatment when indicated, not a routine offer Clinical decision; indicated cases are medical urgency
Palivizumab (Synagis) Older RSV mAb Selected high-risk / specialty cases; largely superseded by nirsevimab/clesrovimab Not routine for healthy term newborns Yes
Circumcision local anesthetic (e.g. lidocaine block) Procedure anesthesia Planned with circumcision before discharge (see Newborn Care) Optional; procedure-linked Yes

Not offered at birth in Florida (common confusion)

These start later (typically ~2 months for the primary infant series), not in the birth hospital stay:

  • DTaP, Hib, PCV, IPV, rotavirus
  • Combination shots that include Hep B later (e.g. Pediarix) — birth Hep B is single-antigen only
  • Hep A, MMR, varicella vaccine (later childhood). Perinatal varicella exposure is VariZIG, not the vaccine
  • Influenza, COVID-19 (not newborn birth-dose routine; COVID vaccine starts at 6 months)
  • BCG (TB) — not routine in U.S./Florida newborns
  • Hepatitis C — no birth vaccine and no HBIG analog

Given to the mother, not the baby:

  • RhoGAM — Rh-negative mothers
  • Tdap, flu, COVID — if still needed postpartum
  • Maternal RSV vaccine (Abrysvo) — pregnancy dose; if given ≥14 days before birth, the infant RSV antibody is usually skipped

Tests, not shots (see Newborn Care): metabolic heel-stick, hearing screen, CCHD pulse ox. Florida also screens for congenital CMV after a failed hearing screen (Fla. Stat. § 383.145) — a test, not a shot.

Decisions to confirm with the hospital

  1. Current Hep B birth-dose standing orders after the Dec 2025 CDC shared-decision change and the Mar 2026 injunction (AAP still pushes routine).
  2. Whether they stock RSV antibody (nirsevimab and/or clesrovimab) for the local FL region / season, and whether maternal Abrysvo was given with adequate timing.
  3. Their Vitamin K and eye ointment consent/refusal paperwork (eye ointment opt-out is religious-written under FL law; confirm they will process a decline).
  4. Documented maternal HBsAg, syphilis, HIV, gonorrhea, and varicella status in the chart so HBIG / penicillin / ARVs / VariZIG are not offered “just in case.”

Key sources

Verification notes

Claim Agents agree? Independently verified?
Eye ointment required by FL statute (§ 383.04), religious written opt-out Yes (A/B/C) Yes — statute text
Attendant penalty if eye prophylaxis skipped (§ 383.07) Added in gap pass Yes — statute text
Vitamin K routine; required in birth centers at 0.5 mg / 24 h Yes (A/B/C) Yes — FAC 59A-11.016
No FDA-licensed oral infant vitamin K in the US Added in gap pass Yes — AAP 2022 / US clinician surveys
Hep B birth dose not FL-mandated; AAP favors universal birth dose Yes (A/B/C) Yes
FL childcare/K–12 still require the Hep B series (not specifically the birth dose); DH 681 is the religious exemption Added in gap pass Yes — FL DOH school guidelines
CDC Dec 2025 shared decision for HBsAg− mothers Yes (A/B/C) Yes — CDC/HHS releases
Mar 2026 preliminary injunction stayed ACIP votes / restores prior schedule guidance (pending appeal) Emphasized by B Yes — Reuters/ACP/CIDRAP/NACCHO coverage of Murphy order
HBIG only if HBsAg+ (or <2000 g with unknown status); not automatic for all “unknown” term infants Gap pass tightened original “or unknown, per protocol” Yes — CDC perinatal algorithm
HBIG + RSV mAb conditional Yes (A/B/C) Yes — CDC guidance
FL RSV seasons are five regions; SE often year-round Implied earlier; regions added Yes — FL DOH RSV reviews
VariZIG for perinatal varicella (5 days before–2 days after) Missing from original list Yes — CDC MMWR VariZIG
Syphilis penicillin / HIV ARVs / untreated GC treatment only if indicated C (penicillin); A (HIV ARVs); gap pass added systemic GC Consistent with CDC/NIH pathways; not universal offers
2-month vaccines are not birth offers Yes (A/B/C) Yes — standard schedule