Recent news on ACIP’s hepatitis B birth‑dose recommendation
The CDC’s Advisory Committee on Immunization Practices (ACIP) recently voted to shift from a universal, automatic hepatitis B birth‑dose recommendation for all newborns to an individual, shared decision‑making approach for infants whose mothers test negative for hepatitis B surface antigen (HBsAg). 12
For infants born to women who are HBsAg‑positive or whose hepatitis B status is unknown, ACIP did not change existing guidance:
these newborns are still strongly recommended to receive the hepatitis B vaccine at birth. 12
Under the new approach, parents of infants born to HBsAg‑negative women are advised to discuss benefits and risks with clinicians and decide whether to administer the birth dose or start the series later, with ACIP suggesting the initial dose should not be given before 2 months of age if it is deferred. 12
Shared decision‑making in this context means considering factors such as household contacts with hepatitis B, close contact with people from regions where hepatitis B is common, and other potential exposure risks when deciding on timing of the first vaccine dose. 2
ACIP emphasized that its updated hepatitis B recommendations are intended to remain aligned with existing coverage under public and private insurance programs, including Vaccines for Children, Medicaid, CHIP, Medicare, and marketplace plans. 2
The committee’s deliberations drew on data showing a marked decline in hepatitis B incidence in the United States since the 1980s, with analyses suggesting that improvements in blood screening, infection‑control practices, and harm‑reduction strategies contributed substantially to reduced transmission. 2
Presentations to ACIP highlighted that the United States’ long‑standing universal birth‑dose policy differs from many other high‑income countries with low hepatitis B prevalence, where a targeted or risk‑based infant vaccination approach is more common. 2
Advocacy and public health groups have submitted comments expressing concern that weakening the universal birth‑dose recommendation could erode a key safeguard against missed maternal screening, documentation errors, or unrecognized household transmission risks. 168
The updated ACIP recommendations still need to be formally adopted by the CDC director before they are fully incorporated into the official U.S. childhood immunization schedule and accompanying provider guidance. 12
Sources:
1. https://www.aha.org/news/headline/2025-12-05-acip-updates-recommendation-hepatitis-b-vaccine-birth
2. https://www.cdc.gov/media/releases/2025/2025-acip-recommends-individual-based-decision-making-for-hepatitis-b-vaccine-for-infants-born-to-women.html
6. https://www.tfah.org/wp-content/uploads/2025/11/TFAHACIPComments_December2025.pdf
8. https://www.vhpb.org/vhpb-sends-letter-to-support-to-acip-on-the-importance-of-timely-universal-hepatitis-b-vaccination-of-newborns/