In a major shift in US vaccine policy, federal health advisers have scrapped the long-standing recommendation for all newborns to receive the hepatitis B vaccine at birth, a policy in place since 1991. The new guidance limits the birth dose to infants whose mothers test positive for hepatitis B or whose infection status is unknown. For the majority of children whose mothers are virus-negative, parents are now encouraged to consult healthcare providers about when to start the three-dose vaccine series, with the first dose recommended no earlier than two months of age.
The decision, supported by Health Secretary Robert F. Kennedy Jr., has sparked widespread criticism from public health experts, the American Medical Association, and the American Academy of Pediatrics, who warn that reversing the universal vaccination policy could increase hepatitis B infections and undermine decades of public health progress. Hepatitis B, a viral infection that can lead to chronic liver disease, had fallen nearly 90% in the US after widespread vaccination.
The advisory committee emphasizes parent choice in vaccination decisions, a move aligned with Kennedy’s long-standing anti-vaccine stance. Critics argue that the policy undermines trust in the vaccine’s safety and efficacy, despite decades of evidence supporting its effectiveness. Vaccine manufacturers, including Merck, Sanofi, and GSK, defended their products as safe, while some lawmakers warned of potential public health repercussions.
Internationally, the World Health Organization continues to recommend universal birth doses, noting that 95% of infected newborns may develop chronic hepatitis B if left unvaccinated. Some European countries, such as Denmark and Finland, recommend vaccination starting at 2–3 months for selective groups rather than universally at birth.
This policy change follows Kennedy’s overhaul of the CDC’s advisory committee, replacing independent experts with members largely aligned with his views. It also forms part of broader alterations to US vaccine guidance, including changes to COVID-19 recommendations and guidance on other pediatric interventions. Public health officials warn that the new approach may reverse decades of gains in controlling hepatitis B infections in children and increase the risk of long-term liver disease nationwide.
