The Advisory Committee on Immunization Practices (ACIP), which advises the Centers for Disease Control and Prevention (CDC), has voted to recommend delaying the hepatitis B vaccine for some infants. The committee's decision, with a vote of 8-3, moves the recommended first dose from birth to two months after birth, but only for children whose mothers test negative for hepatitis B. For infants born to mothers who test positive, the current recommendation—administering the vaccine at birth—remains unchanged.
This change follows more than three decades of routine hepatitis B vaccination at birth in the United States. The vote was postponed from Thursday to Friday due to concerns about unclear voting language presented to committee members. During Thursday’s meeting, ACIP member Joseph Hibbeln stated, “This is the third version of the questions that we have received in 72 hours. We’re trying to evaluate a moving target.” He later added, “I protest the description that the ACIP members have been consulted in developing these questions.”
Hepatitis B can cause serious liver disease and cancer. According to The Evidence Collective, an organization focused on public health communication, “Given that the HBV vaccine is so established as being safe for newborns and that if they are infected within the first year of life, their risk of chronic hepatitis B can be 90% or higher, it is entirely reasonable to recommend the HepB birth doses universally. Perhaps most importantly, before universal screening, 7-11% of children born to hepatitis B-negative mothers still contracted the virus via household or community exposure.”
The CDC maintains that scientific evidence strongly supports both the safety and effectiveness of hepatitis B vaccines and notes that most adverse events are limited to soreness at the injection site. “Most people don’t experience any side effects,” according to agency statements.
During Thursday’s session, Cynthia Nevison from University Colorado Boulder expressed skepticism about universal vaccination at birth. She said there was little evidence supporting significant horizontal transmission among American children and described perceived risks as “overstated,” according to CNN.
Recent changes in ACIP’s composition have drawn attention. Over the summer, Robert F. Kennedy Jr. replaced previous panelists with new members; some have publicly questioned vaccines. In September’s meeting—also marked by unexpected votes—the panel discussed COVID-19 vaccine guidelines and heard presentations on hepatitis B vaccination safety but did not hold a vote on those topics.
Friday’s ACIP agenda also included reviews of vaccine risk surveillance systems and immunization schedules for children and adolescents.
