12/15/2025

Hepatitis B Vaccine at Birth: Breaking Down the New National Recommendation

Key facts beyond the headlines—and what our community needs to know

Authored by the Academy of Medicine of Cincinnati

Editor’s Note:
On December 5, 2025, the Advisory Committee on Immunization Practices (ACIP) voted 8–3 to rescind the longstanding recommendation that all newborns receive a Hepatitis B vaccine at birth. As of this writing, the Acting CDC Director has not yet decided whether to adopt this change. We are sharing this article to summarize the vote, review the evidence supporting the birth-dose schedule, and provide guidance for physicians who may receive questions from parents or caregivers following media coverage. A parent-friendly fact sheet is also available below to support discussions with families.

Introduction — Proposed Changes

On December 5, 2025, ACIP—the advisory committee to the Centers for Disease Control and Prevention (CDC)—voted 8–3 to rescind the longstanding recommendation that all newborns receive a dose of the Hepatitis B vaccine at birth.¹ Instead, infants born to mothers who test negative for the Hep B virus will now have vaccination timing decided through shared clinical decision-making between parents and their doctor. For those infants, the first dose—if given—would be delayed until at least 2 months of age (instead of within 24 hours of birth).¹

This shift marks a major departure from a public-health policy in place for decades—a policy that helped drive a 99% reduction in pediatric Hepatitis B infections.²^,³

Background: Committee & Context

A sudden committee overhaul.
Earlier this year, all 17 previously serving ACIP members—career experts in pediatrics, infectious disease, epidemiology, nursing, and public health—were dismissed and replaced by a smaller group appointed by Robert F. Kennedy Jr. Multiple former members and outside experts warned that the abrupt dismissal of an entire scientific advisory body was unprecedented and may weaken the integrity of immunization policy.⁴^,⁵

New members with markedly different credentials.
The newly appointed panel includes several individuals with limited experience in vaccine science or pediatric infectious disease, and some with long-standing skeptical positions on routine childhood immunizations. This shift in expertise and philosophical orientation has raised questions about whether recommendations are being guided by established evidence or by ideology.⁵

No new evidence prompted the change.
Crucially, ACIP’s decision to end the universal newborn Hepatitis B birth dose was not based on any new research indicating that the vaccine is unsafe or ineffective. The scientific evidence supporting the longstanding schedule remains unchanged, and major medical, public-health, and patient-advocacy organizations have urged the CDC to reject the new recommendation.⁶^,⁷

Why Newborn Hep B Vaccination Was the Rule — and Still Matters

The newborn Hepatitis B (Hep B) vaccine has long been a cornerstone of infant protection—and for good reason. Decades of evidence show it prevents lifelong disease, closes critical gaps in maternal screening, and protects infants from exposures that families may never realize occurred.⁸

Here’s why the birth dose has been—and remains—so important:

Hepatitis B is easily transmitted, often unknowingly. It can pass from mother to child at birth—but also later, through contact with caregivers or household members who may not know they are infected.⁸
Early-life infection is especially dangerous. Infants who contract Hep B in their first months of life have about a 90% chance of developing chronic infection, which sharply increases the long-term risk of cirrhosis and liver cancer.⁸
The birth dose works. When given within 24 hours of birth, the vaccine is up to 90% effective at preventing perinatal infection. Once infants complete the full series, roughly 98% develop long-term immunity.⁸
Universal newborn vaccination changed the trajectory of Hep B in the U.S. Since its introduction in 1991, pediatric cases have dropped by about 99%, an unprecedented public-health success. Experts estimate the policy has prevented more than 500,000 childhood infections and over 90,000 deaths.⁸
Gaps in screening and real-world care still exist. Universal birth-dose vaccination was designed to catch cases missed by maternal testing—including women who were not screened, acquired infection late in pregnancy, or whose infants are exposed after birth. Even with modern screening, these gaps persist.⁸
Delaying vaccination adds risk without adding safety. There is no new credible evidence calling the birth-dose schedule unsafe. The vaccine’s safety record spans decades. What does change with delay is the risk window—infants remain unprotected during a time when infection is most severe.⁸

In short: the birth dose is a proven safety net that protects all newborns—regardless of maternal testing, socioeconomic circumstances, or unexpected exposures. Removing or delaying that dose risks reversing more than 30 years of progress against a preventable, life-altering disease.

Why This Matters for Our Community

Even if Hepatitis B seems rare today, changing the universal birth-dose recommendation could gradually erode community protection. The original policy didn’t just protect newborns—it helped nearly eliminate new childhood infections and dramatically reduce long-term liver disease at the population level.⁸

For expectant parents, new parents, pediatricians, and community health providers, this vote introduces complexity and uncertainty. It means active choices must be made, and families will need clear information and follow-up to ensure infants remain protected.

For Families: Get the Facts

We’ve prepared a parent-friendly fact sheet designed to answer common questions—and address misinformation—about Hepatitis B and the birth-dose vaccine.
Parent/Caregiver Fact Sheet

Conclusion

The newborn Hepatitis B vaccine has protected children for decades. It is safe, effective, and strongly supported by evidence. The scientific basis for universal newborn vaccination has not changed—and understanding the role of the birth dose remains essential to protecting both individual children and community health.

Sources

¹ U.S. Department of Health and Human Services. Summary of ACIP vote on Hepatitis B vaccination, December 5, 2025.
² CIDRAP Vaccine Integrity Project. Universal Hepatitis B Vaccination at Birth. University of Minnesota; December 2, 2025.
³ Public Health Reports. Progress and Unfinished Business: Hepatitis B in the United States, 1980-2019
⁴ Reuters. Coverage of ACIP member dismissal and committee restructuring.
⁵ PBS NewsHour. Analysis of changes to federal vaccine advisory committees.
⁶ STAT News. Reporting on lack of new evidence supporting changes to Hepatitis B birth-dose policy.
⁷ American Academy of Pediatrics. Statement from leading medical, health, and patient-advocacy organizations, 2025.
⁸ CIDRAP Vaccine Integrity Project. Universal Hepatitis B Vaccination at Birth. pp. 1–10.

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