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Parents get a Voice in Hep B Vaccine Timing 
What has Changed and What Stays the Same 

December 5, 2025: Hepatitis B is a liver infection that, in the United States, is overwhelmingly associated with sexual exposure or shared needles during drug use - behaviors that occur later in life. Transmission from mother to baby can happen at birth, which is why mothers are screened during pregnancy and why infants born to Hep B–positive mothers still need protection right away. For healthy newborns whose mothers test negative, the risk of infection in the first months of life is extremely low. During the ACIP meeting, experts also pointed out that Hepatitis B cases in the U.S. had already declined significantly before the universal newborn dose was introduced in the 1990s, largely due to improvements in maternal screening, safer sexual practices, and better blood and infection-control measures, suggesting the birth dose itself played only a minor role in reducing disease.

There was also data presented during the meeting that showed when the Hepatitis B vaccine series is started very early in life, immunity may wane more quickly than when it is initiated later in childhood, suggesting that timing could influence how long protection lasts, especially given that most Hep B risk begins in adulthood.

Despite this, a universal birth-dose Hepatitis B vaccine recommendation has been in place since 1991. Today, the federal Advisory Committee on Immunization Practices (ACIP) voted to end that universal birth-dose requirement and instead limit immediate vaccination to babies with true risk — those with mothers who test positive or whose status is unknown. You can watch the recorded meeting discussion and vote from yesterday and today’s meetings here: https://www.youtube.com/live/LpthhPBFAgI and https://www.youtube.com/live/kUgXRUpKal4.  This shift brings the U.S. more in line with many countries around the world, expecially those with very low disease prevalence, where Hepatitis B vaccination is given later in infancy, or at birth only for babies at truly high risk, rather than universally within the first 24 hours.

For all other families, the first dose will now be recommended at the routine 2-month well-baby visit. So while mainstream media headlines sound dramatic, the practical impact is simply a short delay during a time when a newborn is not going to be sexually active or sharing needles.

This approach also better respects parents. Just hours after birth, most mothers are exhausted, recovering, and often separated briefly from their baby. Making an important medical decision in that moment - without any knowledge of the child’s medical history - is a real challenge. The updated policy supports shared decision-making, allowing families time to recover from birth and talk with their pediatric provider before moving forward.

And if true protection against Hepatitis B is the goal, it’s worth remembering that realistic risk does not begin until adolescence, when behavioral exposure becomes possible. Historically, the Hepatitis B vaccine was scheduled later in childhood — long before any typical risk, but still far more relevant than within hours of birth.

However, even with this change in federal recommendation, earlier this year California moved away from following the ACIP vaccine recommendations, with the passing of AB 144 and the creation of the Western Coast Health Alliance.  This shift means that the California Department of Public Health now sets vaccine policy for our state. Because of that, A Voice for Choice Advocacy does not expect immediate changes to California’s current newborn immunization recommendations. If recommendations shift here, AVFCA will notify our community right away.

Overall, this national decision is a positive step: it recognizes that one-size-fits-all policies are not always appropriate and reinforces the importance of shared decision-making between parents and providers. AVFCA will continue to advocate for transparency, informed consent, and respect for families as true partners in their children’s healthcare.

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C

Christina Hildebrand
President/Founder
A Voice for Choice Advocacy, Inc.
[email protected]
www.AVoiceForChoiceAdvocacy.org