- A new modeling study projects that delaying or omitting the hepatitis B birth dose could increase chronic infections among children by 83% to 225%, depending on vaccine uptake rates.
- The CDC ended its universal recommendation for hepatitis B vaccination at birth in late 2025, shifting to individual-based decision making for infants whose mothers test negative for the virus.
- Up to 90% of infants infected with hepatitis B during their first year develop chronic infection, which can lead to cirrhosis, liver failure, or liver cancer.
- The American Academy of Pediatrics still recommends universal vaccination within 24 hours of birth.
Health and Human Services Secretary Robert F. Kennedy Jr.’s proposed changes to the childhood vaccine schedule have raised alarm among public health experts and researchers.
A new study suggests that delaying or foregoing the hepatitis B shot for newborns could increase chronic infections among children.
In December 2025, the Centers for Disease Control and Prevention (CDC) ended its recommendation for universal hepatitis B vaccination at birth for infants whose mothers test negative for the virus. Instead, the federal health agency
After reviewing the evidence, the CDC, which is overseen by the HHS, concluded that newborns “face little risk of contracting hepatitis,” which deemed the vaccine, typically administered at birth, unnecessary.
Experts say this shift in public health policy wasn’t based on science, and researchers warn of rising infection rates.
“Hepatitis B immunizations have been proven to protect individuals against a serious and significant disease,” said Graham Tse, MD, pediatrician and chief medical officer of MemorialCare Miller Children’s & Women’s Hospital in Long Beach, CA.
“The hepatitis B vaccines have several decades of history and have been proven safe and effective,” Tse said. “There has been no new data or evidence presented or uncovered to support delaying the newborn dose of hepatitis B.”
Here’s what parents should know about making informed decisions with their child’s healthcare team.
A U.S. modeling study published in Annals of Internal Medicine on October 20 projected that delaying the first vaccine dose until 2 months could increase chronic hepatitis B infections among infants by 19% under one scenario.
With shared decision making and lower vaccine uptake, projected increases ranged from 83% to 225%, compared with universal birth-dose vaccination.
The researchers also estimated that up to 1.8 million young adults could remain susceptible to hepatitis B by age 20 under shared decision making, compared with 232,000 under universal birth dosing.
Another study published in
However, these figures are model-based projections, rather than verified outcomes. Actual results will depend on vaccination rates and other factors.
In December 2025, the Centers for Disease Control and Prevention (CDC) adopted a
Under the new approach, parents and healthcare professionals can decide together whether to give the first dose at birth or defer it until the baby is 2 months old.
The change followed an 8 to 3 vote by the Advisory Committee on Immunization Practices (ACIP), marking a departure from longstanding U.S. guidance.
However, infants born to mothers who test positive for hepatitis B or whose infection status is unknown should still receive the hepatitis B vaccine and hepatitis B immune globulin (HBIG) within 12 hours of birth, according to the updated guidelines.
Hepatitis B is a viral infection that affects the liver.
Although some infections resolve, newborns and infants face a higher risk of developing lifelong hepatitis B infection compared with adults.
Up to 90% of infants infected during their first year develop chronic hepatitis B.
“We have actual world evidence that vaccinating newborns for hepatitis B prevents hepatitis B infections later in life and the serious complications of that disease,” Tse said.
Over time, chronic infection can lead to cirrhosis, liver failure, or liver cancer.
“The danger of delaying the newborn hepatitis B shot is that individuals do not get vaccinated and thereby do not have protection against hepatitis B,” Tse said.
Early vaccination helps protect young infants before potential exposure occurs, including situations in which maternal screening misses an infection.
“Newborns can be infected with hepatitis B from a mother who is not aware they have a hepatitis B infection or from exposure later in life,” Tse said.
“The risk is developing a hepatitis B infection, which can potentially lead to liver cancer, fulminant hepatitis, or severe end-stage liver disease.”
In contrast to the CDC, the American Academy of Pediatrics (AAP) still recommends a universal hepatitis B vaccine dose within 24 hours of birth, followed by additional doses during infancy.
The leading pediatric medical organization has raised concerns about the potential consequences of reduced vaccination rates.
The hepatitis B vaccine has decades of safety and effectiveness data.
Tse said the AAP’s vaccine schedule and recommendations are based on decades of study, use, and expert input, and provide the best protection against vaccine-preventable diseases.
Parents who have questions about potential side effects, timing, or their baby’s individual risk should discuss them with a qualified healthcare professional.
“Parents are confused, given the recommendations from CDC, HHS, and Kennedy differ from established and respected groups such as the American Academy of Pediatrics, the Infectious Disease Society of America, and several states,” Tse said.
“Parents desire to keep their children safe, and having differing opinions and confusion will lead to reduced vaccination rates as parents experience doubt as to whom to listen to or believe.”
While the updated CDC policy offers more flexibility for some families, lower vaccination uptake could lead to an increase in chronic hepatitis B infections.
You can also ask how maternal screening results affect your baby’s protection.
An informed conversation with your healthcare professional can help you weigh the evidence and choose a vaccination plan for your baby.
“I see no argument whatsoever for changing the established vaccination schedule for hepatitis B,” Tse said.
“There have been no new studies, no data, nor evidence to justify Kennedy’s proposed changes to the childhood immunization schedule. Delaying vaccinations or skipping vaccinations puts your child at risk for serious and significant diseases, which are all preventable,” Tse said.
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