CDC Ends Universal Hepatitis B Birth Shot Recommendation — New Infant Vaccine Guidance Lets Parents and Doctors Decide

ATLANTA, GA — The U.S. Centers for Disease Control and Prevention (CDC) has formally reversed its long-standing guidance that every newborn in America should receive the hepatitis B vaccine at birth, marking a major shift in the nation’s childhood immunization schedule and opening the door for individual-based decision-making on hepatitis B vaccination for infants born to hepatitis B-negative mothers.

In a policy update announced Tuesday, the CDC said that only infants born to mothers who test positive for hepatitis B or whose infection status is unknown will still receive the hepatitis B vaccine and immune globulin immediately after birth. For all other newborns, parents and pediatricians are now encouraged to consult on whether and when to begin the hepatitis B vaccine series, with the first dose potentially delayed until the infant is at least two months old.

Major Shift From Universal Newborn Hepatitis B Immunization Policy

For more than three decades, U.S. health authorities recommended that all newborn babies receive the hepatitis B vaccine within 24 hours of birth to protect against the virus that can cause chronic liver disease, cirrhosis and liver cancer later in life. That universal birth dose policy was widely credited with reducing hepatitis B infections in children by nearly 90%.

However, the CDC’s Advisory Committee on Immunization Practices (ACIP) voted earlier this month to adopt “individual-based decision-making” — also referred to as shared clinical decision-making — for infants whose mothers test negative for the hepatitis B virus. Under this new approach, parents and doctors will evaluate infection risk, vaccine benefits and possible risks together before deciding on the timing of the hepatitis B vaccine series.

Acting CDC Director Jim O’Neill said the updated recommendation reflects a “rigorous review of the latest evidence” and aims to restore informed consent and personalized healthcare decision-making for parents of low-risk infants.

Vaccine Guidance Update and Public Health Impact

According to the CDC announcement, infants born to hepatitis B-positive mothers or those with unknown status will continue to receive the birth dose of the hepatitis B vaccine and immune globulin — a practice experts agree is crucial to preventing mother-to-child transmission.

For infants born to mothers confirmed hepatitis B-negative, parents are now advised to talk with healthcare providers about the right timing for vaccination, including the option to delay the first hepatitis B shot until at least two months of age, a change officials say can still provide protection while reducing unnecessary interventions for low-risk newborns.

Critics and Public Health Concerns

The policy shift has sparked debate within medical and public health communities. Many pediatricians and infectious disease experts have expressed concern that moving away from universal hepatitis B birth vaccination may lead to confusion among parents, missed shots, and potentially higher rates of infection among young children.

Critics also warn that screening for maternal hepatitis B before delivery is not always foolproof — with gaps in maternal testing and prenatal care potentially putting infants at risk if the initial dose is delayed. Several public health organizations continue to recommend timely childhood hepatitis B vaccination based on its long-proven effectiveness in reducing new infections.

What Parents Should Know About Hepatitis B and Vaccination

Hepatitis B is a serious viral infection that attacks the liver and can lead to both acute and chronic disease. The hepatitis B vaccine has been a cornerstone of U.S. preventive care, with a strong safety record and high effectiveness in protecting children and adults alike.

Under the new CDC guidance:

• Infants born to hepatitis B-positive or unknown status mothers should still receive the vaccine at birth.
• Parents of infants born to hepatitis B-negative mothers now have the option to decide if and when their child should begin the vaccine series, ideally after consulting with a healthcare provider.

Healthcare professionals emphasize that the hepatitis B vaccine remains a safe, effective tool for protecting children against lifelong liver disease and that parents with questions should discuss benefits and risks with trusted doctors.