CDC Panel Revises Hepatitis B Vaccination Guidelines for Newborns

On December 5, 2025, the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) voted 8 to 3 to revise the longstanding recommendation that all newborns receive a hepatitis B vaccine at birth. The new guidance advises that infants born to mothers who test negative for hepatitis B should have individualized decision-making regarding the vaccine, with the initial dose suggested no earlier than two months of age. This marks a significant shift from the universal birth dose policy in place since 1991, which has been credited with a 99% reduction in hepatitis B infections among U.S. children.

The ACIP's decision introduces "individual-based decision-making," also known as shared clinical decision-making. This approach means that parents and healthcare providers should consider vaccine benefits, risks, and infection risks, and decide when or if the child will begin the hepatitis B vaccine series. For infants not receiving the birth dose, the initial dose is suggested no earlier than two months of age. The committee also recommended that parents consult with healthcare providers to decide whether to test antibody levels to hepatitis B surface antigen to evaluate adequacy of protection through serology results.

The decision has drawn criticism from public health experts and organizations. The American Public Health Association (APHA) stated that the change "will leave children vulnerable to unnecessary exposure and preventable illness." APHA Executive Director Georges C. Benjamin, MD, emphasized that the current vaccination schedule is effective in minimizing infection and exposure to hepatitis B. Similarly, the American Academy of Pediatrics continues to recommend routine hepatitis B vaccination for all newborns, expressing concern that the change could lead to an increase in hepatitis B infections and undermine decades of public health progress.

This policy change occurs within a broader context of shifts in U.S. vaccination policies under Health Secretary Robert F. Kennedy Jr., a known vaccine skeptic. Kennedy has previously dismissed the previous ACIP members and replaced them with individuals who have expressed skepticism about vaccines. The new ACIP chair, Dr. Kirk Milhoan, a pediatric cardiologist, has previously supported controversial COVID-19 treatments like hydroxychloroquine and ivermectin.

Experts warn that the shift may lead to rising hepatitis B infections and logistical complications in pediatric care. The recommendation awaits final approval from CDC’s acting director. Critics argue the move risks public health and injects politics into science-based medical decision-making.

The universal birth dose policy, in place since 1991, has been credited with a 99% reduction in hepatitis B infections among U.S. children. The new policy marks a significant departure from this approach, introducing individualized decision-making for infants born to mothers who test negative for hepatitis B.

The ACIP's recent vote to end the universal recommendation for newborn hepatitis B vaccination has sparked significant debate within the medical and public health communities. As the recommendation awaits final approval, stakeholders continue to express concerns about the potential public health implications of this policy shift.