Background Hepatitis B carries a substantial risk of developing hepatocellular carcinoma in children. In the paediatric population, the main route of acquiring hepatitis B is perinatal transmission from mother to child. Current national guidelines in the Green Book for Immunisations, recommend Hepatitis B immunisation to ‘at risk’ neonates who are either born to mothers known to have hepatitis B or mothers who use recreational drugs (high risk lifestyle). Identified children are given a course of hepatitis B vaccination at an accelerated schedule (zero, one, two and twelve months). It is recommended that the child’s anti-Hepatitis B levels must be measured at 14 months.

Aim This study was aimed at studying our compliance with these current guidelines.

Methodology A retrospective database of consecutive immunisations for ‘at risk’ children between 2004 and 2012, were recruited from the child health record database. Data was analysed using Microsoft Excel 2013. Children born to mothers known to have Hepatitis B were designated as Group 1. Children born to mothers who were drug abusers were designated as Group 2.

Results In group 1(n = 30), less than half (12 of 30) children had complete immunisation with the vaccine. 50% (6 of 12) children had serology testing at 14 months with 5 having adequate levels of the antibody.

In group 2 (n = 92), only 14 of 92 children had appropriately completed the course of hepatitis B immunisation. Four of the 14 children had serology testing at 14 months, with 3 having adequate levels of antibodies.

These results were in contrast to routine childhood immunisations, where 83% of children born to hepatitis B positive mothers and 76% children born to mothers with high risk lifestyle, had complete routine immunisation.

Conclusions Suboptimal achievement of Hepatitis B immunisation of ‘at risk’ children reflects current inadequacies of practice and a lack of awareness amongst parents of the necessity of this immunisation. We recommended that the hepatitis B immunisation be part of the routine immunisations and parents of ‘at risk’ children be made aware of this vaccination programme.