CDC Advisory Panel Revises Long-Standing Newborn Hepatitis B Vaccine Guidance

Advisory Committee on Immunization Practices Votes to Alter Newborn Hepatitis B Vaccine Schedule

The Advisory Committee on Immunization Practices (ACIP), a key advisory panel to the U.S. Centers for Disease Control and Prevention (CDC), voted on Friday, December 5, 2025, to revise its long-standing guidance on the hepatitis B vaccine for newborns. The decision, passed with an 8-3 vote, moves away from the universal recommendation for all newborns to receive the vaccine within 24 hours of birth, a policy that has been in place since 1991.

New Recommendations for Infants of Hepatitis B Negative Mothers

Under the updated guidance, for infants born to mothers who test negative for the hepatitis B virus, ACIP now recommends 'individual-based decision-making' in consultation with a healthcare provider regarding 'when or if' to administer the birth dose. Should parents opt against the birth dose, the initial vaccination is suggested to be administered no earlier than two months of age. The previous recommendation for infants born to mothers who test positive for hepatitis B or whose status is unknown remains unchanged; these infants should still receive the birth dose.

Additionally, the panel voted 6-4 with one abstention to recommend that parents, in consultation with healthcare providers, consider testing antibody levels after vaccination to determine the necessity of subsequent doses in the typical three-dose series.

Context and Concerns from the Medical Community

The decision by ACIP follows a recent overhaul of its membership by Health and Human Services Secretary Robert F. Kennedy Jr. The universal newborn hepatitis B vaccination program, established in 1991, has been credited with a 99% reduction in hepatitis B infections among infants and children in the United States. Before this universal recommendation, an estimated 20,000 newborns annually contracted the virus, a number that dropped to fewer than 20 cases by 2022.

The change has drawn significant criticism from numerous medical experts and organizations, including the American Academy of Pediatrics, the American Medical Association, and the American Public Health Association. Critics argue that the decision lacks scientific justification and could lead to a resurgence of hepatitis B infections. Dr. Cody Meissner, an ACIP member who voted against the change, stated, 'We are doing harm by changing this wording.' Concerns have also been raised about the potential impact on insurance coverage for the vaccine, as ACIP recommendations often influence what private insurers are required to cover.

Implications and Next Steps

While ACIP's recommendations are highly influential, they are not final until approved by the CDC Director. Several state health departments, including those in New York, Connecticut, and Maryland, have already reaffirmed their commitment to the universal newborn hepatitis B vaccination guidance, indicating potential divergence in state-level policies. The long-term effects of this revised guidance on public health and vaccination rates will be closely monitored by medical professionals and public health officials across the nation.