The U.S. panel that advises the Centers for Disease Control and Prevention (CDC) has voted to change its long-standing recommendation of giving a birth-dose of hepatitis B vaccine to all newborns.
Under the new guidance, infants born to mothers who test negative for hepatitis B surface antigen will no longer automatically receive the first dose within 24 hours of birth. Instead, vaccination for these infants will be considered on a case-by-case basis, with parents and clinicians deciding whether, when, and how to begin the vaccine series.
For babies whose mothers test positive for hepatitis B — or whose status is unknown — the birth-dose recommendation remains unchanged. For others, if parents and providers choose to defer vaccination, the first dose should be given no earlier than two months of age.
The committee also suggested a more individualized approach for follow-up doses. Rather than automatically administering the standard three-dose regimen, ACIP recommended that parents consult their child’s healthcare provider and consider testing the child’s antibody levels to assess whether further doses are needed.
The change ends a universal birth-dose policy that had been in place since 1991 — a policy credited with dramatically reducing hepatitis B infections in infants and children.
Despite the shift, coverage for the hepatitis B vaccine — under federally funded programs and insurance — remains unchanged. The new recommendation, categorised as “shared clinical decision-making,” allows flexibility in timing and decision-making depending on individual circumstances.
