What happened?
A federal vaccine advisory panel has voted to roll back the long-standing U.S. recommendation that all newborns receive a hepatitis B vaccine at birth.
On Friday, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) voted 8–3 to recommend hepatitis B vaccination at birth only for infants born to mothers who test positive for the virus or whose infection status is unknown.
If approved by the CDC’s acting director, the change would reverse a policy that has been in place for more than 30 years.
Why the decision is controversial
For decades, the universal birth dose has been credited with sharply reducing hepatitis B infections in children. In contrast, critics of the rollback warned that narrowing the recommendation could lead to missed cases and higher infection rates.
“This has been working,” said Dr. Grant Paulsen, representing the Pediatric Infectious Diseases Society. He questioned why a policy with proven results was being changed without clear evidence of harm.
Similarly, Dr. Cody Meissner, the longest-serving current member of the panel, voted against the change. He emphasized that hepatitis B vaccines are safe, effective, and well-studied, adding that weakening the recommendation could expose more children to preventable infection.
What else the panel voted on
In addition, the committee narrowly approved a second proposal affecting infant immunization schedules.
By a 6–4 vote, with one abstention, ACIP recommended testing antibody levels after each hepatitis B dose. Under this approach, some infants may receive fewer than the standard three shots if early testing shows sufficient immunity.
However, CDC officials raised concerns. Dr. Adam Langer, who oversees hepatitis prevention efforts, noted that existing clinical trials tested a full three-dose regimen, not abbreviated schedules. As a result, he warned that the new approach relies on assumptions that remain unproven.
Concerns about committee composition
Notably, the current ACIP panel was restructured earlier this year by Health Secretary Robert F. Kennedy Jr., who removed previous members and appointed a new slate.
Several of the current voting members have publicly questioned vaccine safety in the past, raising concerns among medical organizations about the direction of U.S. vaccine policy.
Committee vice chair Robert Malone described the debate as rooted in unresolved questions about vaccine harm, despite decades of safety data.
Why health experts are alarmed
Hepatitis B spreads through blood and other bodily fluids and can be transmitted from mother to child during childbirth. When infection occurs in infancy, it often becomes chronic, dramatically increasing the risk of liver cancer and cirrhosis later in life.
Because early vaccination provides lifelong protection, experts argue that the birth dose remains essential, especially when screening gaps exist.
What happens next?
The recommendation now awaits review and approval by CDC Acting Director James O’Neill. Until then, the current policy technically remains in place.
However, public health leaders warn that even a policy shift toward “shared clinical decision-making” could undermine vaccine confidence and reverse decades of progress.
