On December 5, 2025, a seismic shift in U.S. public health policy sent shockwaves through medical circles, families, and international observers alike. The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) voted 8-3 to end the universal recommendation that all newborns receive the hepatitis B vaccine at birth—a policy that had been in place since 1991 and credited with nearly eradicating infant hepatitis B infections in the United States.
The new guidance, now backed by President Trump and Health and Human Services Secretary Robert F. Kennedy Jr. (RFK Jr.), instead urges an “individual-based decision-making” approach. Parents of infants whose mothers test negative for hepatitis B are advised to consult with healthcare providers, with vaccination delayed until at least two months of age for those who opt out of the birth dose. This move, which has ignited fierce debate, marks a dramatic departure from three decades of evidence-based public health practice.
Medical and public health organizations wasted no time voicing their alarm. Over 40 leading groups—including the American Academy of Pediatrics, American Medical Association, Infectious Diseases Society of America, and March of Dimes—released a joint statement declaring themselves “deeply alarmed” by the ACIP’s actions. According to The New York Times, the statement read, “ACIP’s actions will harm children, their families and the medical professionals who care for them. That is why we are joining together to speak up.” The organizations emphasized that no new data was presented to justify the change, and they called on CDC leaders to reject the ACIP’s recommendation in favor of retaining the current, evidence-based approach.
The impact of the universal birth dose is hard to overstate. Since its implementation in 1991, annual hepatitis B infections among infants and children have plummeted by 99%, dropping from approximately 16,000–18,000 cases per year to fewer than 20 today. Medical experts estimate that more than 500,000 childhood infections and 90,100 childhood deaths have been prevented since 1994 thanks to this policy. The birth dose has been credited with saving countless lives and preventing untold suffering from a virus that, when contracted in infancy, leads to chronic infection in 90% of cases and, ultimately, cirrhosis, liver cancer, or early death for one in four chronically infected children.
Despite this track record, the ACIP’s new guidance, as reported by Devdiscourse, has opened the door to a patchwork of vaccine policies. Multiple states—including Illinois, New York, New Jersey, Maryland, California, and Washington—have already announced they will not follow the ACIP’s new recommendation. “The current guidance in Illinois remains unchanged,” the Illinois Department of Public Health stated, reaffirming their commitment to universal newborn vaccination. The Illinois Immunization Advisory Committee is set to review the latest ACIP recommendation later this month, but for now, the state stands firm.
Federal agencies and private insurers are expected to continue covering the hepatitis B vaccine under current policies, according to the Centers for Medicare & Medicaid Services. However, experts warn that weakening the national recommendation could lead to confusion among parents and healthcare providers, potentially resulting in declining vaccination rates and increased risk of outbreaks.
Behind the scenes, the ACIP’s composition has changed dramatically in recent months. All current members were appointed by Secretary RFK Jr., who dismissed the panel’s 17 previous members in June 2025. RFK Jr., founder of the anti-vaccine group Children’s Health Defense, has previously and falsely claimed that the hepatitis B vaccine is a “likely culprit” in autism. Several of the newly appointed members have expressed skepticism about vaccines or have been associated with spreading vaccine misinformation. Among them is Dr. Robert Malone, who has been known for disseminating misinformation about COVID-19 vaccines, and Retsef Levi, an MIT professor with no medical training who strongly argued against the universal birth dose during the recent meeting.
The New York Times captured the anxiety this change has caused among new parents. Eleanor Trenary, a mother in St. Paul, expressed her concern: “What if we can’t protect our second baby as well as we could our first?” She added, “It feels like a brave new world to not trust CDC recommendations anymore. All of us just want to do what we can to keep our kids safe.” The shifting guidance has made an already stressful time even more daunting for families, especially as the Trump administration signals more changes may be on the horizon for other childhood vaccines.
Medical experts are united in their warning: delaying the hepatitis B vaccine could have dire consequences. Research cited by the joint statement of medical organizations projects that the new policy could result in at least 1,400 preventable hepatitis B infections among children each year, 300 additional cases of liver cancer, 480 preventable deaths, and over $222 million in excess healthcare costs annually. About 16% of expecting mothers do not get tested for hepatitis B during pregnancy, according to the CDC, increasing the risk that infected newborns could go unprotected if the birth dose is skipped.
Internationally, the ripple effects of the U.S. decision are being closely watched. In Australia, for example, hepatitis B cases declined by 30% in 2024, a success widely attributed to early vaccination practices. Health authorities there and elsewhere are monitoring the situation, wary of any potential erosion of public confidence in vaccination programs. As BBC has reported, nations often look to the CDC for guidance, meaning changes in U.S. policy could influence global health strategies.
The political dimension of the ACIP’s decision cannot be ignored. The change is supported by President Trump and Secretary RFK Jr., and critics argue that it prioritizes political considerations over scientific evidence. Senator Bill Cassidy of Louisiana, a physician and chair of the Senate Committee on Health, Education, Labor and Pensions, called the change “a mistake” and urged acting CDC Director Jim O’Neill to reject the ACIP’s vote. O’Neill, for his part, stated that the public “benefited from the committee’s well-informed, rigorous discussion.”
For now, the ACIP’s recommendation awaits formal adoption by the CDC director before becoming official policy. In the meantime, leading medical societies have pledged to continue endorsing universal hepatitis B vaccination for newborns, regardless of the advisory panel’s stance. The debate has laid bare a fundamental tension in American healthcare: the struggle to balance political priorities with evidence-based medicine, and the crucial importance of maintaining public trust in vaccination programs.
As the dust settles on this contentious decision, families, doctors, and policymakers are left grappling with uncertainty—and a renewed sense of urgency to protect the youngest and most vulnerable among us.
