Quick Read
- CDC’s advisory panel voted to end universal hepatitis B vaccination for newborns, recommending individual decision-making for babies born to virus-negative mothers.
- Medical groups including the American Academy of Pediatrics and AMA strongly oppose the change, warning of increased risk and public confusion.
- The new guidance suggests delaying the first hepatitis B vaccine dose until at least two months of age if not given at birth.
- Committee members cited politicization and lack of scientific basis for the change; CDC’s final decision is pending.
- Experts stress that the hepatitis B vaccine remains safe, effective, and crucial for preventing serious liver disease.
CDC Advisers Vote to End Universal Hepatitis B Vaccination for Newborns
In a highly charged meeting broadcast for the first time from a television studio on the CDC’s Atlanta campus, advisers to the US Centers for Disease Control and Prevention (CDC) voted to abandon the longstanding recommendation for universal hepatitis B vaccination of newborns. Instead, the committee now urges individualized decision-making for babies born to mothers who test negative for the virus—placing the responsibility squarely on parents and their healthcare providers.
The Advisory Committee on Immunization Practices (ACIP), now composed of members handpicked by US Health and Human Services Secretary Robert F. Kennedy Jr., reached this decision amidst a swirl of controversy and public scrutiny. Kennedy, a vocal critic of vaccine mandates, had earlier dismissed the committee’s previous members, setting the stage for a radical departure from decades of public health practice.
Medical Community Pushes Back: “Reckless” and “Dangerous”
The response from leading medical organizations was swift and severe. The American Academy of Pediatrics (AAP) reaffirmed its support for routine hepatitis B vaccination for all newborns, warning that the new recommendation could lead to a resurgence of preventable infections. Dr. Sandra Adamson Fryhofer, trustee of the American Medical Association (AMA), called the move “reckless,” emphasizing that it undermines public trust in a vaccine proven to save lives.
“Administering the birth dose is crucial for protecting children from both perinatal and early postnatal transmission of Hepatitis B virus,” Fryhofer said, noting the risk of chronic liver disease, cirrhosis, and liver cancer if infants remain unprotected. The AMA urged the CDC to reject the advisory panel’s recommendation, insisting that families deserve evidence-based guidance rooted in gold-standard science.
Local health departments are also bracing for the fallout. Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials, warned that up to two-thirds of pediatric hepatitis B cases occur in families where a mother initially tested negative but the virus was later transmitted within the household or community. The CDC’s own data shows that routine childhood immunizations prevented more than 6 million hepatitis B illnesses between 1994 and 2023.
Confusion, Distrust, and Potential Risks for Newborns
The shift toward “shared clinical decision-making” has sparked concern that parents and providers will be left confused, potentially resulting in missed or delayed vaccinations. Dr. Demetre Daskalakis, former CDC immunization chief, cautioned that the new wording could inadvertently signal risk where none exists, given the vaccine’s decades-long record of safety and effectiveness. “What confusion means is the wrong medical decision,” he told CNN, urging providers to heed the advice of reputable medical organizations rather than the ACIP.
The panel’s recommendation stipulates that, for infants not receiving the birth dose, the initial hepatitis B vaccine should be given no earlier than two months of age. This delay could leave newborns vulnerable during a critical window, especially if household or community transmission occurs undetected. The committee also suggested considering blood tests after the first dose to assess immunity before further vaccination, adding another layer of complexity for families and clinicians.
Some experts on the committee, including Dr. Cody Meissner and Dr. Joseph Hibbeln, voiced strong opposition, warning that “we are doing harm by changing this wording.” Hibbeln echoed: “This has a great potential to cause harm, and I simply hope that the committee will accept its responsibility when this harm is caused.”
Politics, Science, and the Role of Aluminum Adjuvants
The ACIP meeting itself reflected the broader politicization of vaccine policy in the US. The decision to televise the proceedings, directed by Kennedy’s press office, underscored efforts to make the committee’s work more visible—and arguably more contentious. Kennedy’s longstanding skepticism of vaccine safety has influenced the committee’s focus, with several members raising concerns about vaccine ingredients such as aluminum adjuvants.
Aluminum salts have been used as adjuvants in US vaccines for nearly a century, helping to strengthen immune responses and reduce the number of doses needed. According to the CDC and peer-reviewed studies published in Pediatrics, the use of aluminum-containing adjuvants is safe, with only minor local reactions like redness or swelling. Large-scale studies in Denmark and the US have consistently found no link between aluminum in vaccines and conditions like asthma, eczema, or autism—a point vigorously defended by scientific organizations.
Despite this, ACIP member Dr. Evelyn Griffin suggested a possible connection between vaccination and “profound autism,” repeating a claim thoroughly debunked by the Autism Science Foundation and other experts. Dr. Cody Meissner responded by referencing the notorious, discredited work of Andrew Wakefield, cautioning against wasting time on disproven theories at the expense of genuine scientific inquiry.
Attorney Aaron Siri, known for litigating vaccine injury cases, was also invited to present at the meeting—a move criticized as inappropriate by US Senator Bill Cassidy, a physician. Siri argued that patients harmed by vaccines are often ignored, fueling distrust and hesitancy. Dr. Meissner countered, pointing out the low rates of infectious disease in the US as evidence of vaccine success.
Comparisons with Other Nations: Is the US Unique?
Some ACIP members argued that the new approach aligns the US with peer nations like Denmark, where universal newborn hepatitis B vaccination is not routine. But CDC hepatitis expert Dr. Adam Langer highlighted critical differences: Denmark’s population is much smaller, nearly all pregnant women are screened for hepatitis B, and prenatal care is universally accessible. In the US, gaps in screening, follow-up, and healthcare access mean that universal newborn vaccination has been a crucial safety net.
Recent studies in Canada, which uses a more localized approach, have actually suggested benefits to universal birth dosing. The US, Langer emphasized, is not directly comparable to countries with different healthcare infrastructure and population dynamics.
What’s Next? CDC’s Final Decision Pending
The CDC typically aligns with its advisory panel but retains the final authority over vaccine recommendations. Acting CDC Director Jim O’Neill, appointed after the abrupt firing of Dr. Susan Monarez, faces mounting pressure from medical groups and public health officials to reject the ACIP’s new guidance.
For now, the future of newborn hepatitis B vaccination in the US hangs in the balance. Pediatricians, public health experts, and advocacy groups are urging the CDC to prioritize evidence-based policies that protect the most vulnerable—America’s newborns—from a preventable, potentially devastating disease.
Assessment: The ACIP’s vote to end universal hepatitis B vaccination for newborns marks a watershed moment in US public health policy. While framed as empowering parental choice, the decision has triggered widespread concern among experts who warn of increased risk, confusion, and erosion of trust in vaccines. The scientific consensus on the vaccine’s safety and effectiveness is clear; departing from it could have lasting, unintended consequences for children’s health nationwide.