US panel votes to end universal hepatitis B shots for newborns

A US federal advisory group for the Centers for Disease Control and Prevention (CDC) has voted to end the longstanding recommendation that all newborns receive a hepatitis B (HBV) vaccination immediately after birth. The decision marks a major shift in national vaccine policy, raising concerns among public health experts while reflecting new leadership at federal health agencies.

On December 5, the Advisory Committee on Immunization Practices (ACIP) voted 8–3 to support "individual-based decision-making" for hepatitis B vaccination in babies whose mothers have tested negative for the virus, as reported by NPR.

The recommendation reverses a policy in place since 1991, when the United States first urged universal HBV vaccination at birth. Public health analyses over the last three decades suggest that the policy prevented nearly 90,000 deaths.

The World Health Organization currently advises that all children receive HBV vaccinations at zero, one, and six months. The ACIP’s new recommendation diverges sharply from this standard by suggesting that infants who do not receive the shot at birth should get their first dose "no earlier than two months of age." Several committee members objected to this change during debate.

The outcome follows a dramatic change in Acip membership. In June, Health Secretary Robert F. Kennedy Jr., a longtime critic of certain vaccine ingredients and advocate for expanded research, dismissed all former members of the panel and appointed replacements who share a more skeptical stance toward vaccinations. Critics have argued that Kennedy’s views could weaken public confidence in routine childhood immunizations. The vote on hepatitis B represents the most significant change since Kennedy began restructuring vaccine policy in the US

Shortly after the ACIP decision, President Donald Trump issued a directive ordering health officials to re-evaluate the country’s entire childhood vaccination schedule. In a White House memo, he instructed them to "review best practices from peer, developed countries for core childhood vaccination recommendations" and indicated that the US should adopt other countries’ schedules if they are found to be superior. The memo also noted that several developed nations require fewer injections for infants than the US.

The ACIP recommendations guide mandatory vaccination policy for the US Centers for Disease Control and Prevention (CDC). The CDC’s acting director must still approve the proposed change, but historically the agency aligns with ACIP guidance. The shift is not expected to affect insurance coverage for the vaccine.

Although the new policy discourages an automatic birth dose for infants born to mothers who tested negative for HBV, the panel continues to insist that newborns whose mothers are positive for HBV infection must receive a birth vaccination.

HBV is spread through contact with bodily fluids, including via caregiving interactions, and can cause life-threatening complications such as liver cancer, cirrhosis, and liver failure. Because many people infected with HBV show no symptoms, they may not know they are contagious and can unwittingly transmit the virus, including to infants.

Public health professionals have expressed concern that altering the schedule could promote the false perception that the hepatitis B vaccine is unsafe. During the tense two-day meeting preceding the vote, Dr. Cody Meissner argued the proposed change would increase infections, stating, "The hepatitis B vaccine recommendation is very well established. We know it's safe and we know it's very effective. And to make the changes that are being proposed, we will see more children and adolescents and adults infected with hepatitis B."

Supporters of the change point to international differences in vaccination approaches. Committee member Retsef Levi, who voted in favour, argued that the current US guidance is "misaligned" with other countries.

The decision reflects the broader agenda of Health Secretary Kennedy, who has already narrowed access to COVID-19 vaccines, separated chickenpox vaccines for young babies from a combined shot, and revised the CDC’s position on potential vaccine links to autism.

By Nazrin Sadigova