In a major and controversial shift, the CDC’s Advisory Committee on Immunization Practices voted on 5 December 2025 to end the universal hepatitis B birth dose recommendation for babies born to mothers who test negative for the virus. The advisory panel for the US Centers for Disease Control and Prevention voted to end the universal policy and now recommends the birth dose only for babies whose mothers test positive for Hepatitis B or whose maternal status is unknown. For infants of hepatitis B negative mothers, the panel now suggests shared decision making between parents and doctors on whether to give the vaccine at birth or delay it until later infancy. The recommendation will take effect only if it is signed by Acting CDC Director Jim O’Neill. The move has triggered widespread concern among public health experts who believe the decision could undo more than three decades of progress in preventing chronic liver disease.
For over 30 years, the birth dose of the Hepatitis B vaccine has played a crucial role in cutting down childhood infections. Experts point out that the universal policy reduced pediatric Hepatitis B cases by more than 90 percent in the US. They now fear that removing the immediate newborn shot could allow infections to rise again, especially because many mothers may carry the virus without showing symptoms.
Doctors and infectious disease specialists have criticized the decision as scientifically unsound. They argue that the birth dose protects infants during the most vulnerable window when transmission from mother to child is most likely. Critics also worry that relying on parental discretion could lower vaccine uptake and add confusion for new parents who already struggle to navigate immunization schedules
Medical professionals in the US from the American Medical Association and the American Academy of Pediatrics have also questioned the timing of the policy change. They note that authorities reconstituted the advisory panel earlier this year, replacing several long serving experts. This has raised concerns about political influence on a public health decision that should rely solely on evidence and medical consensus.
For over 30 years, the birth dose of the Hepatitis B vaccine has played a crucial role in cutting down childhood infections. Experts point out that the universal policy reduced pediatric Hepatitis B cases by more than 90 percent in the US. More precise estimates show that since the policy began in 1991, childhood hepatitis B cases have fallen by 95 to 99 percent, and newborn infections dropped from nearly 20,000 per year to fewer than 20 annually. They now fear that removing the immediate newborn shot could allow infections to rise again, especially because many mothers may carry the virus without showing symptoms.
Doctors and infectious disease specialists have criticized the decision as scientifically unsound. They argue that the birth dose protects infants during the most vulnerable window when transmission from mother to child is most likely. Medical evidence shows that about 90 percent of babies infected with hepatitis B at birth go on to develop chronic infection, which sharply raises their lifetime risk of liver failure and liver cancer. Critics also worry that relying on parental discretion could lower vaccine uptake and add confusion for new parents who already struggle to navigate immunization schedules.
Medical professionals in the US from the American Medical Association and the American Academy of Pediatrics have also questioned the timing of the policy change. They note that authorities reconstituted the advisory panel earlier this year, replacing several long serving experts. The previous panel was dismissed and a new committee was appointed under US Health Secretary Robert F. Kennedy Jr, raising concerns among experts about political influence on long standing public health policy.
Dr. Zachary Rubin, a US based double board certified pediatrician and allergist immunologist, explained in a recent social media video that the hepatitis B vaccine is universally recommended in the first 12 to 24 hours of life to prevent transmission during birth. He said most babies who become infected at this stage develop lifelong chronic hepatitis B, with a high risk of cirrhosis and liver cancer. Dr. Rubin also stressed that the vaccine has been used safely for decades and significantly reduces infection risk when the full three dose series is completed.
Experts also point out that prenatal screening is not foolproof. A significant number of pregnant women in the US are not screened every year or may deliver before results are confirmed, which is one of the main reasons universal birth dosing was introduced in the first place.
The policy change has sparked conversations across the globe, including in India where perinatal Hepatitis B transmission remains a significant public health challenge. The topic entered the Indian public sphere after entrepreneur and ZoHo founder, Sridhar Vembu shared his views on social media. He urged parents to research newborn vaccinations and questioned the need for a Hepatitis B shot for a one day old baby. His post followed the US advisory panel vote and quickly gained traction online. His comments quickly circulated online and drew a mixed response.
While some parents said they appreciated the call for informed decision making, many doctors in India expressed concern. They cautioned that such statements could unintentionally fuel vaccine hesitancy at a time when consistent immunisation is critical for controlling preventable diseases. Pediatricians emphasise that India still records a high burden of Hepatitis B and that delaying the birth dose could put newborns at serious risk. India is estimated to have 37 to 40 million people living with chronic hepatitis B, with many infections acquired in infancy or early childhood.
Unlike the latest US move, India’s National Immunization Schedule continues to recommend a universal hepatitis B birth dose within 24 hours, followed by doses at 6, 10, and 14 weeks under the Universal Immunization Programme. Indian experts warn that weakening confidence in this schedule could reverse hard won public health gains.
Indian hepatologist Dr. Zubin Sharma responded on social media by stating that hepatitis B is a chronic liver virus that directly contributes to liver cancer later in life and that vaccination remains the only reliable protection, especially in India and across Asia where the burden remains high.
Global health experts warn that while parents in the US may still choose the birth dose even under the revised guidance, the larger danger lies in the message such policy shifts send worldwide. In high burden countries like India, even a small fall in newborn vaccination could translate into thousands of additional cases of chronic liver disease and liver cancer in the coming decades.
References:
Centers for Disease Control and Prevention (CDC). “ACIP Recommends Individual-Based Decision-Making for Hepatitis B Vaccine for Infants Born to Women Who Test Negative for the Virus.” Press release, December 5, 2025. https://www.cdc.gov/media/releases/2025/2025-acip-recommends-individual-based-decision-making-for-hepatitis-b-vaccine-for-infants-born-to-women.html
World Health Organization (WHO). “Hepatitis B.” Fact Sheet. July 23, 2025. https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
World Health Organization (WHO). “Hepatitis B Vaccines: WHO Position Paper, July 2017.” Weekly Epidemiological Record, 2017. https://www.who.int/publications/i/item/WER9227
American Academy of Pediatrics (AAP). “Fact-Checked: Hepatitis B Vaccine Given to Newborns Reduces Risk of Chronic Infection.” June 25, 2025. https://www.aap.org/en/news-room/fact-checked/fact-checked-hepatitis-b-vaccine-given-to-newborns-reduces-risk-of-chronic-infection/
Ministry of Health and Family Welfare, Government of India. “National Immunization Schedule.” National Health Mission documents, accessed December 8, 2025. https://nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/report/National_%20Immunization_Schedule.pdf
Children’s Hospital of Philadelphia Vaccine Education Center. “Hepatitis B: The Disease & Vaccines.” 2025. https://www.chop.edu/vaccine-education-center/vaccine-details/hepatitis-b-vaccine
Pan American Health Organization (PAHO). “Hepatitis vaccines.” PAHO: Regional recommendations aligning with WHO on birth-dose vaccination. 2025. https://www.paho.org/en/tag/hepatitis-vaccines
(Rh/ARC/MSM)
