The decision by the Trump-influenced panel has alarmed many physicians and public health experts
CDC vaccine panel votes to scrap long-standing hepatitis B shot at birth
New guidance urges parents of low-risk newborns to consult a doctor and delay first dose
Critics warn move could raise infections of a virus that can cause cirrhosis and liver cancer
A key federal vaccine advisory panel has voted to end more than three decades of guidance that all newborns receive a hepatitis B shot within hours of birth, a move that has alarmed many public-health experts.
In an 83 vote Friday, the Advisory Committee on Immunization Practices (ACIP) at the Centers for Disease Control and Prevention recommended scrapping the universal birth dose of hepatitis B vaccine. The recommendation came after the panel heard presentations from multiple vaccine skeptics.
The change would roll back guidance that has been in place since 1991, when the CDC adopted routine infant hepatitis B vaccination as a cornerstone of its strategy to curb infections. Scientists have credited the policycombined with follow-up childhood doseswith driving down new hepatitis B infections in the U.S., particularly among children.
The panels recommendation must still be endorsed by the acting CDC director before it can take effect.
Panel urges case-by-case decisions and later start to vaccination
Under the new guidance, ACIP said if a pregnant person tests negative for hepatitis B, parents should consult a physician about whether their newborn needs the first dose at birth. For infants who skip the birth dose, the committee suggested delaying the first shot until at least two months of age.
The vote follows a sweeping overhaul of the committee earlier this year by Health Secretary Robert F. Kennedy Jr., who removed all previous members and installed a new panel.
Supporters of the change argued that most newborns face low risk of hepatitis B infection and raised questions about possible, but unproven, long-term side effects of the vaccine.
Patients are unaware that their babies are getting a lot of interventions in the first few hours of life, said Dr. Evelyn Griffin, an obstetrician on the panel who voted for the new recommendation, according to a Wall Street Journal report. Parental rights are violated.
Griffin suggested the vaccine could be linked to autoimmune conditions, while acknowledging that no high-quality studies have demonstrated such a risk.
Critics say evidence shows birth dose is safe and effective
Other committee members and outside experts strongly opposed the move, saying it was not based on the weight of scientific evidence.
They pointed to randomized trials and more than three decades of real-world data supporting the safety of the hepatitis B vaccine in newborns, as well as continuous monitoring through vaccine-safety surveillance systems that have not identified unusual harms.
Public-health specialists have long warned that limiting the birth dose to babies of women known to have hepatitis Bor delaying vaccinationcan create dangerous gaps in protection. Prenatal hepatitis B testing is typically done in the first trimester, leaving time for a pregnant person to become infected later in pregnancy. Some never get tested at all.
Beyond transmission from mother to baby, hepatitis B can spread through contact with infected blood and body fluids, including via shared household items such as razors, toothbrushes or washcloths. Household and early-childhood transmission are key reasons global health agencies have pushed the birth dose.
The birth dose is critical to preventing hepatitis B, which is the leading cause of liver cancer worldwide, said Chari Cohen, president of the Hepatitis B Foundation. It is not a virus you want your baby to have.
Background: What is hepatitis B and why does the birth dose matter?
Hepatitis B is a viral infection that attacks the liver. Many adults who become infected clear the virus on their own, but when infection occurs in infancy or early childhood, it is much more likely to become chronic, lasting for life. Chronic hepatitis B can cause cirrhosis (severe scarring of the liver), liver failure and liver cancer. Globally, hepatitis B is estimated to cause hundreds of thousands of deaths each year, largely from liver-related complications.
The virus is spread through blood and certain body fluidsvia sexual contact, shared needles, or from mother to child during pregnancy or birth. Because newborns immune systems respond differently, an infant infected at birth has up to a 90% chance of developing chronic hepatitis B, compared with fewer than 10% of healthy adults who are infected.
The hepatitis B vaccine, introduced in the 1980s and widely recommended for U.S. infants since 1991, is one of the most intensively studied vaccines. Decades of data show it to be highly effective in preventing infection and associated liver disease, with serious side effects considered rare according to major health authorities including the CDC and World Health Organization.
The birth dose is designed as a safety net: it helps protect infants whose mothers have been misdiagnosed, infected late in pregnancy, or never tested, and it reduces opportunities for household transmission in the first months of life. Many countries, guided by the WHO, recommend a hepatitis B shot within 24 hours of birth, followed by additional doses in infancy.
Public-health experts fear that delaying or skipping the birth dose could leave more babies vulnerable during a critical windowespecially in communities with higher rates of hepatitis B or limited access to prenatal care and testing.
Next steps for the controversial recommendation
The ACIP vote does not automatically change U.S. immunization policy. The committees recommendations must be reviewed and accepted by the CDCs acting director before they become part of the agencys official vaccine schedule.
In the meantime, health systems, pediatricians and parents are likely to face questions about whether to follow the long-standing practice of giving the hepatitis B shot at birth or the new, more limited guidance if it is adopted.
Many public-health and liver-disease experts say they will continue urging parents to accept the birth dose, arguing that the benefits and safety of early hepatitis B vaccination are well established, while the risks of delaying are borne by the smallest and most vulnerable patients.
Posted: 2025-12-05 16:34:35
