US vaccine advisers voted 8 to 3 to end the universal hepatitis B birth dose after 34 years

Most coverage of American vaccine policy in the past year has been a fight about vaccines in general. The narrower documented fact is a single instrument with a recorded tally: on 5 December 2025 the Advisory Committee on Immunization Practices voted 8 to 3 to remove the universal recommendation that every newborn receive a dose of hepatitis B vaccine at birth.

The change is specific about who it covers. For infants born to mothers who test negative for hepatitis B, the committee moved to what it called individual based decision making, with the first dose to be given no earlier than two months of age and the timing decided between parents and clinicians. For infants born to mothers who test positive, or whose status is unknown or untested, universal vaccination continues, and the dose is still recommended within 12 hours of birth. ABC News reported that providers should also weigh risk factors such as household members with hepatitis B or contact with people from countries where the virus is endemic. The policy the vote replaced had stood since 1991.

The scale of what the 1991 policy is credited with is not in dispute among the sources. Scientific American reported that before universal newborn vaccination, roughly 18,000 infants and children in the United States contracted hepatitis B each year, and that cases fell 99 per cent between 1990 and 2019. Transmission from mother to child occurs during pregnancy and childbirth, and chronic infection acquired in infancy can lead to liver disease or liver cancer decades later. The standard schedule the change alters was three doses, at birth, at one to two months and between six and 18 months.

The dissent inside the room was recorded at the time. Cody Meissner, a committee member, said we are doing harm by changing this wording, and I vote no. Joseph Hibbeln, another member, said the decision was unconscionable. Two members said they had seen no documented evidence of harm from the birth doses. Helen Chu of the University of Washington said the two month delay is time that a child is at risk for a vaccine preventable disease. Yvonne Maldonado of Stanford said it is really devastating to think about losing that. Rochelle Walensky, a former CDC director, was sceptical that the individual conversation would happen, saying they may or may not have a discussion about how important it is. William Schaffner of Vanderbilt University told PBS NewsHour that this is the group that can't shoot straight.

The American Public Health Association objected the same day. Its executive director, Georges C. Benjamin, said the recommendation will leave children vulnerable to unnecessary exposure and preventable illness. The association's stated ground of objection is evidentiary rather than rhetorical: it said committee members failed to provide scientific evidence to show the long term health benefits of delaying vaccination. That is a narrow and testable complaint, and it is the one worth holding on to, because a recommendation to delay is a claim about comparative outcomes and therefore needs comparative data.

One procedural point matters and is frequently blurred. An ACIP vote is a recommendation, not policy; it becomes policy when the director of the Centers for Disease Control and Prevention adopts it. On the day of the vote ABC News reported that the acting director, Health and Human Services deputy secretary Jim O'Neill, was expected to sign off on the change. The date on which that adoption formally occurred could not be established from any document opened for this article.

The hepatitis B vote has since been overtaken by a wider restructuring. CIDRAP at the University of Minnesota reported on 13 August 2026 that an executive order signed on 10 August 2026 cuts the universal vaccine tier from the 18 diseases in the 2024 CDC recommendation to 11, proposes splitting the combined measles, mumps and rubella vaccine into separate shots, spreads vaccines across more visits and creates a tiered recommendation system. CIDRAP noted that the order does not specifically mandate hepatitis B policy changes. Republican senator Bill Cassidy said this executive order is wrong. The American Academy of Pediatrics said dividing MMR would mean additional injections without improved protection. CIDRAP also cited a study of 2,560,035 children which produced an autism risk estimate of 0.97 for MMR timing, where 1.0 indicates no difference, with an uncertainty range of 0.91 to 1.03.

Three things remain open. The exact date the hepatitis B recommendation became CDC policy is not established here. Whether the American Academy of Pediatrics has published its own separate hepatitis B schedule, as has been reported, could not be verified against the academy's own document. And a reported federal court ruling on post 2025 schedule changes could not be checked against the judgment itself, so it is not relied on in this article.