The standard argument against Hepatitis B vaccine at birth is basically that the baby is not at risk of contracting Hepatitis B.

But did you know that even in cases where mothers test positive, the vaccine STILL DOES NOT MAKE SENSE for the newborn to receive?

Here is a why..

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 in cases 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. http://shorturl.at/iKU69 

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 for Hep B in early pregnancy can develop antibodies prior to giving birth. http://shorturl.at/qAJMW 

These maternal Hep B 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. PMID 27469237

The authors conclude that vaccination may not be the optimal choice for infants of mothers testing positive for hepatitis B. PMID 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. PMID 29670610

This is an interesting study that recognizes the newborn immune system as distinct and unable to respond to vaccination like adults. PMID 29670610

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". So basically they are admitting the reason to vaccinate is..

"because they can"

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. PMID 24434322

The author admits that this lack of benefit may be due to inefficacy of the hepatitis B immunization program itself. PMID 24434322