Federal health officials shook up on December 5, the long-standing childhood immunization guideline, leaving decisions about when and whether to vaccinate children against hepatitis B to parents and caregivers.
The U.S. Centers for Disease Control and Prevention (CDC) expert panel found that the vaccine, a three-shot series that previously included a dose at birth, is effectively discretionary.
The panel previously recommended one dose of the vaccine for newborns – regardless of the hepatitis B status of the biological parent – followed by a second dose between 1 and 2 months of age. A final dose was recommended between 6 and 18 months of age.
The new guidance also says that babies who were not vaccinated at birth, but whose parents eventually want to vaccinate them, should not receive their first vaccination against hepatitis B until they are at least two months old. The CDC continues to recommend that children born to a hepatitis B-positive parent – or to a parent whose hepatitis B status is unknown – be vaccinated at birth.
The panel also voted to change existing guidelines to raise the question of whether all children need the full three-dose series of hepatitis B vaccines. The new guidance recommends that parents consult with health care providers to decide whether to test for hepatitis B immunity levels before proceeding with a second or third dose of the vaccine. Several meeting participants, including a CDC expert, expressed concern that scientific data does not support this approach.
The recommendations will become final once adopted by the CDC director.
Why vaccinate newborns against hepatitis B?
During the two-day meeting of the Advisory Committee on Immunization Practices (ACIP) held on December 4 and 5, 2025 – which included heated discussions among panelists and outside experts about some members’ unsupported views on vaccination – multiple panelists suggested that the hepatitis B vaccine poses significant health and safety risks to newborns. But the available science shows that the opposite is true.
Vaccination immediately after birth “maximizes the effectiveness of the vaccine in preventing infection in newborns,” it said American Academy of Pediatrics (MONKEY).
Hepatitis B is transmitted through blood and sexual fluidsand can spread from a pregnant person to their child both in the womb and during childbirth. If left untreated, the inflammation is caused by a chronic hepatitis B infection can lead to scarring of the liver causing the organ to fail.
People infected with chronic hepatitis B at birth and never treated have a 25 percent lifetime risk of developing liver cancer. according to the Hepatitis B Foundation. Those infected with hepatitis B have a 4 percent annual risk of liver cancer, depending on whether they have cirrhosis.
Jeopardizing the public health progress of the past 34 years
Before 1991, when the U.S. launched a vaccination program to eradicate hepatitis B infections during pregnancy and childbirth, about 18,000 to 20,000 babies were diagnosed annually, said Dr. James Campbell, vice chairman of the American Academy of Pediatrics’ committee on infectious diseases. Nowadays there are only twenty to thirty.
Most hepatitis B infections can be associated with a specific risk factor, such as intravenous drug use, sex with an infected person, or being born to a hepatitis B-positive individual. But that can’t be up to a third, Campbell said.
“We don’t know where everyone is getting it from,” Campbell added. “Giving all babies the vaccine protects them against both known and unknown risks of getting hepatitis B.”
The panel is also expected to debate the rest of the childhood vaccine program on December 5. ACIP already changed federal vaccine guidelines for measles, mumps, rubella, varicella and COVID-19 in September 2025.
Editor’s note: This is an updated and abridged version of a story originally published on September 19, 2025.
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