Refusing vaccinations in the maternity hospital - what parents in Kazakhstan need to know
A Tengri Health correspondent investigated which vaccinations are administered in the first days of life, why parents and other family members must undergo examinations if a vaccination is refused, and at what point a newborn can be discharged home.
Which vaccinations are given in the first days of life
According to Ainagul Kuatbayeva, a high-level epidemiologist, the first days after birth are a period when the child is just adapting to the environment and their immune system is still forming. Consequently, vaccinations according to the national preventive immunization schedule begin right in the maternity hospital.
Newborns in Kazakhstan receive two primary vaccinations:
Hepatitis B — within the first 12 hours of life.
BCG (Tuberculosis) — on the second to fourth day.
Why newborns need the Hepatitis B vaccine
The epidemiologist notes that one of the main reasons is the risk of the virus being transmitted from an infected mother to the baby during childbirth. Furthermore, the younger the child at the time of infection, the higher the probability that the infection will become chronic.
"Viral Hepatitis B affects the liver and can lead to the development of chronic hepatitis, cirrhosis, and liver cancer. Vaccination prevents infection with the Hepatitis B virus and its severe long-term consequences," the expert explains.
About the speaker: Ainagul Kuatbayeva is an epidemiologist, senior physician, Candidate of Medical Sciences, Associate Professor, and Director of the branch of the "Scientific and Practical Center for Sanitary and Epidemiological Expertise and Monitoring" at the National Center for Public Health of the Ministry of Health.
According to her, this vaccine is recommended for all newborns, not just children whose mothers are already aware they have Hepatitis B. The infection can proceed for a long time without obvious symptoms and remain undetected.
"According to WHO data, when infection occurs in infancy or early childhood, chronic infection develops in approximately 95 percent of infected children," the specialist notes.
However, as mentioned, Hepatitis B is not the only infection infants are vaccinated against in the maternity hospital. In the first days of life, they are also offered BCG—the vaccine against tuberculosis.
Why newborns need the BCG vaccine
Ainagul Kuatbayeva points out that tuberculosis remains a pressing health issue for Kazakhstan. Despite a steady decline in cases, the infection continues to circulate among the population.
"According to official data from the Ministry of Health, 2,919 cases of tuberculosis were registered in the first half of 2026, with an incidence rate of 14.23 per 100,000 population. Compared to the same period in 2025, the incidence decreased by 11 percent. Positive dynamics are also observed among children; however, nearly a third of pediatric tuberculosis cases are identified only after the family seeks medical help on their own," the doctor says.
Infants and young children are in the high-risk group. After infection, they face a higher risk of rapid disease progression and severe forms of the illness, the epidemiologist emphasizes.
Therefore, for healthy newborns without medical contraindications, the BCG vaccine is administered in the maternity hospital on the second to fourth day after birth, in accordance with tuberculosis prevention regulations, the expert clarifies.
"The primary goal of vaccination is to establish specific protection for the child as early as possible, before a potential encounter with the tuberculosis pathogen," says Ainagul Kuatbayeva.
However, the specialist warns that BCG does not protect a person from all types of tuberculosis infection and does not provide lifelong protection against all forms of the disease..
Its main task is to reduce the risk of the most severe types of tuberculosis specifically in early childhood. This primarily includes:
Tuberculous meningitis — an infection affecting the membranes of the brain.
Miliary or generalized tuberculosis — when the infection spreads throughout the entire body.
"According to WHO data, BCG administered during the neonatal period provides up to 90 percent protection against severe forms of tuberculosis," our speaker notes.
What if parents do not want to vaccinate?
According to the expert, parents have the right to refuse vaccination after being informed about the vaccine and the potential consequences of such a decision.
The refusal is recorded in the medical information system, but the procedure does not end there, specifically when it involves a refusal of the BCG vaccine.
A critical point arises here: a newborn who has not been vaccinated against tuberculosis leaves the maternity hospital without specific protection against severe forms of the disease. Therefore, it is vital to eliminate the risk of the infant coming into contact with anyone who may have undiagnosed tuberculosis.
To ensure this, the mother, father, and all individuals who will be living with the child must undergo a tuberculosis screening and obtain a medical certificate from a primary healthcare provider.
Providing such a certificate is a requirement under the regulations for discharging a newborn who has not received the BCG vaccine.
Can a discharge be delayed due to a refusal of the BCG vaccine?
Ainagul Kuatbaeva states that regulatory documents do not establish a specific timeframe for which a maternity hospital can detain a mother and child solely because of a refusal of the BCG vaccine.
In a typical situation, the length of stay in a maternity hospital depends primarily on the health of the mother and child, medical indications, and the infant's readiness for discharge.
Therefore, the specialist believes it is not entirely accurate to say that a maternity hospital "withholds" a mother and child as punishment for refusing the vaccination.
"This is not about a penalty for refusing the BCG vaccine, but about following the established protocol for the safe discharge of a newborn who remains without specific vaccine protection against severe forms of tuberculosis," she emphasized.
What if the parents change their minds?
If parents change their minds, the child can be vaccinated later at a primary healthcare facility.
Up to two months of age, the BCG vaccine is administered without a preliminary Mantoux test; however, if the child is already older than two months, the test is required before vaccination. If the result is negative, the infant receives the shot.
Consequently, if parents initially refuse the BCG vaccine but later decide to vaccinate the child, they should contact their local pediatrician or general practitioner at their registered clinic.