The Centers for Disease Control and Prevention officially ended its decades-long recommendation for all newborns to receive the Hepatitis B vaccine at birth. This significant policy shift, adopted by the CDC on December 16, 2025, follows a vote by its Advisory Committee on Immunization Practices. The change means parents of infants born to mothers who test negative for Hepatitis B will now engage in individual decision-making with their doctors about the birth dose^{[1][2][3][4][5]}. For babies not vaccinated at birth, the CDC now suggests the first dose should be given no earlier than two months of age^[1][6][7][4]. ### Policy Reverses Longstanding Guidance The universal birth dose recommendation had been a cornerstone of public health guidance for 34 years, in place since 1991^{[1][2][8][5][9]}. Under the previous policy, all infants received the Hepatitis B vaccine shortly after birth to prevent the serious liver infection. The CDC's Acting Director, Jim O'Neill, stated the new recommendation "restores the balance of informed consent to parents whose newborns face little risk of contracting hepatitis B"^[1][4][5][9]. He added that the decision reflects ACIP's thorough review of available evidence^[1][4]. The Advisory Committee on Immunization Practices (ACIP) voted 8-3 to approve the change on December 5, 2025^{[6][7][10][9]}. ACIP members were appointed by Health and Human Services Secretary Robert F. Kennedy Jr.^{[6][11][12][9]}. The committee also recommended that all pregnant women be tested for Hepatitis B, a test already covered by insurance programs^[10]. ### Medical Community Expresses Strong Concerns Many medical experts and organizations, including the American Academy of Pediatrics (AAP) and the American Medical Association (AMA), strongly oppose the new guidelines^{[6][12][13][14]}. They warn the policy reversal could lead to a rise in preventable infections, severe liver disease, and even deaths among children^{[6][8][11][15][12][13][5][9][14]}. Dr. Jake Scott, a clinical associate professor of infectious diseases at Stanford Medicine, criticized the decision. "There's no scientific rationale for this," Scott told Healthline. "They are taking away the safety net, guaranteeing that more babies will become chronically infected, and years later, some will die of liver disease that could have been prevented"^[9]. ### Decades of Progress at Risk The universal birth dose policy is widely credited with a dramatic reduction in Hepatitis B infections. Between 1990 and 2019, serious infections among American children dropped by 99%^{[8][15][13][14]}. This success saw annual cases fall from 16,000 to fewer than 20^[13]. Medical groups fear the new approach will reverse this progress. A recent modeling analysis projected that delaying the birth dose for infants whose mothers are not known to have Hepatitis B could result in at least 1,400 preventable infections in children each year^[15]. The analysis also estimated 300 excess cases of liver cancer and 480 preventable deaths annually, alongside over $222 million in additional healthcare costs^[15]. Senator Bill Cassidy, a physician and Republican from Louisiana, called the change "a mistake"^[6][8]. ### Doctors Vow to Continue Universal Vaccination Despite the CDC's updated guidance, many healthcare providers, medical societies, and state health departments plan to continue recommending and administering the Hepatitis B vaccine to all newborns at birth^[12][16]. They emphasize that the vaccine is safe and highly effective. Dr. Natasha Bagdasarian, representing the Association of State and Territorial Health Officials, warned that "adding excessive or ambiguous language around shared decision-making for routine vaccines muddies the waters, creates a false sense of scientific uncertainty and places unnecessary burden on clinicians and families"^[8]. Dr. Sandra Adamson Fryhofer, an AMA trustee, stated that "rolling back this recommendation creates confusion and doubt about vaccines, reverses hard-won progress in preventing hepatitis B, and will undoubtedly result in completely preventable illness and death"^[14]. ### Unchanged Recommendations for High-Risk Infants The CDC maintains its strong recommendation for the Hepatitis B vaccine within 12 hours of birth for babies born to mothers who test positive for the virus or whose Hepatitis B status is unknown^{[1][11][7][15][3][13][4]}. This targeted approach aims to prevent perinatal transmission from infected mothers to their infants. The CDC is also reviewing a secondary ACIP recommendation. This suggests parents should consult with a healthcare provider about serology testing to determine if a subsequent Hepatitis B vaccine dose is needed^{[1][6][7][3][4]}. Critics argue that serology testing is not an adequate basis for determining immunity^[13]. This policy change marks a significant shift in U.S. infant vaccination strategy, with the medical community expressing deep concern over its potential impact on public health.

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