After some back and forth, The CDC vaccine advisory has finally voted to end the “blanket” hepatitis B vaccination for all newborns at birth, and move focus to individual cases of babies born to mothers who test negative for the virus. The birth dose however, will continue as a recommended vaccine for all infants who were born to mothers with hepatitis B, or when their hepatitis B status remains unclear.
What particular modifications have taken place
For more than 30 years, U.S. policy recommended that every baby receive a hepatitis B shot within 24 hours of birth, regardless of the mother’s infection status. The universal method brought about a 99% reduction in hepatitis B infections which occurred in children and teenagers.
In December 2025, the Advisory Committee on Immunization Practices (ACIP), which guides CDC policy, voted 8–3 to stop recommending a routine birth dose for babies born to mothers who test negative for hepatitis B. Instead, parents in this group are now advised to decide with their child’s doctor when or whether to start the vaccine series, with any delayed first dose given no earlier than 2 months of age.
Who should still get the birth dose
The new guidance does not change recommendations for babies at higher risk. A birth dose of hepatitis B vaccine is still strongly advised for:Infants born to mothers who test positive for hepatitis B.Infants whose mothers’ hepatitis B status is unknown at delivery.The newborn vaccine, together with hepatitis B immune globulin for exposed babies, must be administered to stop the development of permanent infection, which would result in severe liver damage. The hospital needs to maintain these high-risk protocols as standard perinatal care practices.The term “individual-based decision-making” refers to a decision-making process which focuses on the choices made by individual people or entities.The CDC presents this new method through two names: “individual-based” and “shared clinical decision-making.” The decision process requires parents and clinicians to assess between these two options…The benefits of protection against hepatitis B.
The very low but perceived risks of the vaccine.
The baby faces two risks for hepatitis B exposure because he lives with someone who has hepatitis B, or is contact with people from regions where hepatitis B is common.However, parents may still choose to:Give the hepatitis B shot at birth, as before.The first dose should be delayed until the child reaches at least 2 months of age.The vaccine needs to be denied only in cases which are considered exceptional.The use of unclear terminology about “shared decision-making” according to experts, will create confusion among parents which might result in delayed infant vaccinations.
Why did advisers push for this change
The ACIP meeting included presenters who stated that birth dosing for all newborns does not provide significant additional protection, because the United States now has low hepatitis B rates and better blood testing, safer dialysis and harm reduction programs. The committee received an analysis which demonstrated that the birth dose vaccine contributed minimally to the significant decrease in acute hepatitis B cases, which occurred during the 1980s.
The ACIP members observed that the United States stood alone as a high-income nation, because other countries with similar economic status do not provide birth doses to mothers who test negative for hepatitis B. They supported a policy change from universal birth dose administration, because it would align U.S. practice with international standards, and concentrate on protecting the most at-risk groups.
Why are doctors worried
Many pediatric and infectious disease specialists have publicly opposed the decision. They point out that:The universal birth‑dose strategy has nearly eliminated early childhood hepatitis B in the U.S.Real-world systems contain defects, because tests become lost during filing, mothers can receive incorrect labels and essential risk factors remain undetected, which requires all newborns to receive the vaccine at birth for protection.The pediatric leadership group has labeled this change as a negative development, because they predict it will create fresh vaccination gaps, which will result in increasing numbers of childhood infections. Some pediatric practices have announced their decision to maintain their current policy of giving birth dose vaccinations to all newborns despite the ACIP’s updated recommendations.
What does this mean for parents
The hepatitis B shot which parents need to give their newborns at birth now depends on the test results of their mother because of this change. Instead:You will likely be asked to discuss the pros and cons of a birth dose with your baby’s doctor.If you choose to delay, your baby should start the hepatitis B series at or after 2 months of age.Complete protection requires patients to finish their entire three-dose vaccination schedule. Partial vaccination or relying only on antibody testing after one or two doses, is not considered a reliable substitute for completing all recommended shots. Insurance coverage is not expected to change; the vaccine will remain covered by public and private plans.
