A major shift in US vaccine policy has emerged after a federal advisory committee voted to end the long-standing recommendation that all newborns receive the hepatitis B vaccine immediately after birth.
The Advisory Committee on Immunization Practices (ACIP) voted 8–3 in favor of a new “individual-based decision” model for babies born to mothers who test negative for the virus. This replaces the universal newborn vaccination approach in place since 1991—a policy credited with preventing nearly 90,000 deaths over the past three decades.
The revamped committee was appointed by US Health Secretary Robert F. Kennedy Jr, who dismissed every previous member in June and replaced them with individuals known for their critical stance on vaccines.
ACIP guides the US Centers for Disease Control and Prevention (CDC) on vaccine schedules, though the CDC’s acting director must still formally approve the new recommendations.
A Divisive New Recommendation
The new guidance says newborns who skip the birth dose should not receive their first hepatitis B shot before two months of age—a stipulation that several panelists strongly opposed.
Public health experts fear the change could fuel vaccine hesitancy and undo decades of progress in preventing HBV infections.
Dr. Cody Meissner, who voted against the change, warned that “the hepatitis B vaccine recommendation is rock-solid,” emphasizing its long-proven safety and effectiveness. He predicted that the new policy would inevitably lead to more infections among children and adults.
The committee still advises that infants born to mothers who test positive for hepatitis B must receive the birth dose immediately, and insurance coverage for the vaccine is not expected to change.
Concerns Over Rising Risk
Hepatitis B is a contagious liver infection primarily spread through bodily fluids. Pregnant carriers can pass the virus to newborns during delivery, and babies infected at birth often develop chronic HBV, which increases the risk of liver cancer, cirrhosis, and liver failure.
Because the virus can spread through indirect contact—such as shared razors or toothbrushes—doctors argue that limiting vaccines to babies of known-positive mothers overlooks those who receive false negative test results or have no access to proper screening.
During two tense days of meetings, numerous physicians criticized ACIP for reconsidering universal newborn protection. Dr. Joseph Hibbeln called the voting options “incredibly problematic,” while Dr. Meissner accused the panel of giving in to “baseless skepticism.”
Supporters of the change, including committee member Retsef Levi, argued that the US birth-dose policy is inconsistent with many countries. The World Health Organization recommends doses at birth, one month, and six months, whereas the UK schedules vaccines at 8, 12, and 16 weeks unless the mother is infected.
Political and Medical Backlash
The policy reversal quickly triggered political pushback. Republican Senator Bill Cassidy—who supported Kennedy’s appointment despite voicing concerns about his vaccine views—condemned the decision.
“As a liver doctor who has treated hepatitis B for decades, this change is a mistake,” Cassidy said. “The birth dose is safe, effective, and it is a recommendation, not a mandate.”
Since taking office, Kennedy has aggressively reshaped US vaccine policy and questioned the necessity of the early hepatitis B dose, claiming the virus is largely associated with sexual transmission and needle sharing. However, extensive research shows HBV can spread in everyday household settings as well.
The final decision now rests with the CDC’s acting director, who must determine whether to approve or override the controversial new guidance.