CDC Approves Changes to Hepatitis B Newborn Recommendation

In a landmark decision that marks the most significant alteration to the U.S. childhood immunization schedule in decades, the Centers for Disease Control and Prevention (CDC) has formally approved a recommendation from its advisory panel to drop the universal hepatitis B vaccine dose at birth for most newborns.

Acting CDC Director Jim O’Neill signed off on the update yesterday, December 16, 2025, implementing changes proposed earlier this month by the Advisory Committee on Immunization Practices (ACIP). The panel, entirely reconstituted by Health and Human Services Secretary Robert F. Kennedy Jr., voted 8-3 on December 5 to end the long-standing policy—introduced in 1991 and strengthened in 2005—that all infants receive the hepatitis B vaccine within 24 hours of birth.

Under the new guidance:Newborns whose mothers test positive for hepatitis B or whose status is unknown will still receive the vaccine at birth.For infants born to mothers who test negative (the vast majority), the birth dose is no longer routinely recommended.

Instead, parents are advised to consult with healthcare providers to decide “when or if” to administer it, with the first dose potentially delayed until at least 2 months of age.This shift fulfills a priority long advocated by vaccine skeptics, including Secretary Kennedy, who has questioned the necessity of early vaccination for low-risk infants. Supporters argue it restores parental choice and aligns policy with individualized risk assessment.

Hepatitis B is a viral infection that can lead to chronic liver disease, cirrhosis, and cancer. The universal birth dose was credited with dramatically reducing childhood infections—preventing over 6 million cases and nearly 1 million related hospitalizations since its adoption, according to prior CDC data.

Transmission can occur perinatally from infected mothers or later through blood or bodily fluids.Critics of the change, including major medical organizations like the American Academy of Pediatrics and infectious disease experts, warn it could reverse decades of progress. They point to risks from undiagnosed maternal infections, testing errors, or later exposures, potentially increasing cases among children.

The ACIP’s December meeting was marked by intense debate. Panel members, many appointed by Kennedy after he replaced the previous committee in June 2025, emphasized theoretical concerns and parental feedback over traditional data-driven approaches. Dissenting members highlighted a lack of evidence supporting the delay.

President Trump weighed in on December 5, ordering a broader review of the childhood schedule, calling the U.S. an “outlier” compared to some countries without universal newborn dosing.

This is the latest in a series of vaccine policy shifts under the current administration. Earlier in 2025, the CDC adopted ACIP recommendations for shared decision-making on COVID-19 vaccines and restrictions on combined MMR-varicella shots for toddlers.Insurers have signaled they will continue covering vaccines based on pre-2025 recommendations in some cases, reflecting unease with the new process.

Public health leaders express concern over eroding trust in the schedule, which influences doctor guidance, school requirements, and free vaccine programs.As of today, the updated childhood immunization schedule reflects these changes on the CDC website.

Experts urge parents to discuss options with providers, while monitoring for potential rises in hepatitis B cases in coming years.The ACIP is expected to continue reviewing the full childhood schedule, with potential further revisions on the horizon.

Signpost NewsDesk

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