CDC Drops Universal Newborn Hepatitis B Vaccine Recommendation, Recommends Parental Consultation

In a move that has stunned public health experts, the Centers for Disease Control and Prevention (CDC) has abandoned its long‑standing recommendation that every newborn receive a hepatitis B vaccine within 24 hours of birth.

The Policy Shift

The change comes after the CDC’s vaccine advisory committee, newly appointed by Health Secretary Robert F. Kennedy Jr. following the dismissal of its previous members, voted earlier this month to alter the guidance. Acting CDC Director Jim O’Neill accepted the recommendation on Tuesday, marking the final step for the agency’s policy to take effect. In a statement, O’Neill said, “We are restoring the balance of informed consent to parents whose newborns face little risk of contracting hepatitis B.”

Under the new guidance, women who test negative for hepatitis B are advised to discuss with their health‑care providers whether their babies should receive the first dose within 24 hours of birth. The CDC now recommends waiting until at least two months of age for the first hepatitis B shot if a birth dose is not given. Babies born to mothers who test positive or whose status is unknown still receive the vaccine within the first day of life.

The agency is also reviewing a secondary recommendation that parents consult health‑care providers about testing children for hepatitis B antibodies before deciding on second doses. The hepatitis B vaccine is normally administered as a three‑dose series.

A Long‑Standing Recommendation Now Overturned

The CDC had recommended a birth dose of the hepatitis B vaccine since 1991. The policy has been credited with a dramatic decline in pediatric acute hepatitis B cases—falling 99 % from 1990 to 2019. The virus can be transmitted from mother to child during delivery, and not all pregnant women receive testing. Because there is no cure, preventing infection is crucial.

The advisory committee’s discussion was described by many public‑health experts as rife with misinformation and cherry‑picked data, and it ignored decades of evidence that the vaccine is safe and effective when given shortly after birth. After the committee’s meeting, doctors, political leaders and health officials called on O’Neill to ignore the suggested change and maintain the CDC’s recommendation, but those appeals were unsuccessful.

Expert Opposition

Senator Bill Cassidy, a liver‑disease specialist from Louisiana, posted on X earlier this month: “Ending the recommendation for newborns makes it more likely the number of cases will begin to increase again. This makes America sicker.” Cassidy is among several medical professionals who publicly urged O’Neill not to adopt the advisory panel’s recommendations.

Pediatricians are expected to continue recommending that parents vaccinate their newborns. The Department of Health and Human Services has stated that the new recommendations will not affect insurance coverage of the shots, and the vaccine will remain available to newborns through the Vaccines for Children Program, which provides free shots for uninsured or underinsured children.

A Pattern of Controversial Guidance

The hepatitis B decision is the latest in a series of CDC policy changes that have been criticized for lacking scientific backing. After Kennedy replaced the long‑standing Advisory Committee on Immunization Practices in June, the new panel has largely expressed skepticism of vaccines.

O’Neill, a former investment executive with no medical background, became acting CDC director in August after Kennedy abruptly fired the previous director, Susan Monarez. Kennedy said Monarez was fired for being untrustworthy; Monarez countered that Kennedy dismissed her for refusing to blindly approve the panel’s recommendations.

Other recent changes include:

• The CDC altered a webpage that had once stated unequivocally that vaccines do not cause autism, now claiming studies have not ruled out a link.
• In October, O’Neill urged vaccine manufacturers to develop separate shots for measles, mumps and rubella, despite no evidence supporting such a split.
• In September, the CDC updated guidance advising pregnant women to consider avoiding acetaminophen because of a possible connection to autism, even though the bulk of scientific literature has not found a definitive link.

State-Level Responses

Many states have begun to defer to recommendations from newly formed public‑health alliances or professional medical societies such as the American Academy of Pediatrics (AAP). The AAP continues to recommend a first dose of the hepatitis B vaccine within 24 hours of birth, followed by additional doses at 1‑2 months and 6‑18 months.

Key Takeaways

• The CDC has dropped its universal newborn hepatitis B vaccine recommendation, advising parents of negative mothers to consult providers.
• The change follows a vote by a newly appointed advisory committee and acceptance by acting director Jim O’Neill.
• Experts warn that delaying the vaccine could lead to a resurgence of infections and increased liver disease risk.

The policy shift underscores a growing divergence between CDC guidance and the broader medical consensus on vaccine safety and efficacy.

Closing

The CDC’s decision to alter the hepatitis B vaccine recommendation marks a significant departure from a three‑decade standard that has protected millions of children. While the agency maintains that insurance coverage and free vaccination programs remain unchanged, the move has sparked intense debate among health professionals, policymakers, and the public.

The long‑term impact of this policy change remains to be seen, but the conversation it has ignited highlights the importance of evidence‑based guidance in public‑health decision‑making.