ACIP Revises Hepatitis B Birth Dose Recommendation

On Friday, the Advisory Committee on Immunization Practices (ACIP) voted 8–3 to modify the long-standing universal hepatitis B birth-dose policy, adopting new guidance that distinguishes recommendations based on maternal HBsAg status. The decision marks a significant shift for clinicians, who have followed universal newborn vaccination for more than three decades.

Under the new recommendation, infants born to mothers who test positive for HBsAg or whose status is unknown should continue to receive both the hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) at birth. For infants born to mothers who are HBsAg-negative, ACIP now supports an individual-based, shared decision-making approach between clinicians and parents to determine whether the birth dose should be administered. If families opt not to receive the vaccine at birth, the committee advises initiating the hepatitis B vaccine series no earlier than age 2 months.

“These recommendations on hepatitis B immunization maintain consistency of coverage for all payment mechanisms, including entitlement programs such as the Vaccines for Children Program, Children’s Health Insurance Program, Medicaid, and Medicare, as well as insurance plans through the federal Health Insurance Marketplace,” the HHS said in a press release.

ACIP had originally planned to vote on the birth-dose recommendation at its September meeting, but members were unable to reach agreement on vaccination timing—a key issue given the previous CDC guidance recommending administration within 12 to 24 hours of birth. The timing question resurfaced at the start of the December meeting, prompting another delay before the committee ultimately moved forward with Friday’s vote.

Reference
ACIP recommends individual-based decision-making for hepatitis b vaccine birth dose in infants born to women who test negative for the virus. US Department of Health and Human Services. Accessed December 5, 2025. https://www.hhs.gov/press-room/acip-recommends-individual-based-decision-making-hepatitis-b-vaccine-birth-dose-infants-born-women-test-negative-virus.html