CDC Advisers Back Away From Universal Hepatitis B Vaccination for Newborns, Alarming Health Experts

Advisers to the U.S. Centers for Disease Control and Prevention on Thursday approved a controversial shift in longstanding national vaccination policy, voting to scale back the universal recommendation that all newborns receive the first dose of the hepatitis B vaccine at birth. The decision, made by a CDC advisory panel reshaped earlier this year under Health Secretary Robert F. Kennedy Jr., has drawn unusually sharp criticism from pediatric and infectious-disease specialists, who say the move risks reversing decades of progress in preventing a potentially fatal viral infection.

Under the new guidance, infants born to mothers who test negative for the hepatitis B virus would no longer automatically receive the vaccine within 24 hours of delivery. Instead, the panel recommended that parents and clinicians use “shared clinical decision-making” to determine whether a newborn should be vaccinated at birth — a term more commonly used for nonroutine immunizations and one that many experts said could introduce confusion and barriers to access.

“For newborns, we are vaccinating to protect the infant from a potentially fatal disease,” said Dr. Cody Meissner, a Dartmouth College pediatrician and longtime vaccine expert who opposed the change. “We know this vaccine is safe. We know it is highly effective. Altering the guidance will result in more children becoming infected with hepatitis B, and some of them will die prematurely.”

Modeling studies presented at the meeting estimated that delaying the first dose until an infant’s two-month visit could lead to approximately 1,400 additional infections annually, including hundreds of cases of liver cancer and nearly 500 deaths. Because hepatitis B can survive on surfaces for up to a week and is often transmitted unknowingly, experts say early vaccination provides critical protection long before potential exposure occurs.

The American Academy of Pediatrics said Thursday that it would continue to recommend vaccination for all infants within 24 hours of birth and warned that the panel’s action could create harmful uncertainty for families, particularly those with limited access to consistent medical care.

The vote caps months of rising tension inside the CDC following moves by Mr. Kennedy to overhaul federal vaccine policy. Earlier this year, he replaced the entire Advisory Committee on Immunization Practices — a panel that has shaped U.S. vaccination schedules for decades — with his own appointees. In one of its first actions, the committee called for removing thimerosal, a preservative long shown to be safe, from some influenza vaccines, citing debunked concerns.

Federal scientists said privately that Thursday’s vote reflected growing ideological influence over a process historically insulated from political pressure. Several current and former CDC officials said they were caught off guard in recent weeks when the agency’s website quietly altered language regarding childhood vaccines and autism, suggesting that a link “cannot be ruled out.” The shift contradicts an extensive body of research across multiple countries involving millions of children that has found no association between vaccines and autism.

Public health experts said the updated language could reinforce misinformation that has fueled declining vaccination rates and a resurgence of preventable diseases such as measles. A spokesperson for the Department of Health and Human Services defended the change, arguing that previous statements dismissing any link “were not evidence-based,” a claim scientists strongly disputed.

“Parents are now left to navigate mixed messages from institutions that used to speak with one voice,” said Dr. Angela Rasmussen, a virologist at the Vaccine and Infectious Disease Organization in Canada. “The result is confusion, and confusion leads to lower vaccination rates.”

The CDC’s recommendations are not binding but heavily influence insurance coverage, state policies and clinical practice nationwide. Health officials warn that erosion of consensus-based guidance may leave families unsure whom to trust.

“For parents, the best path forward remains unchanged,” Dr. Meissner said. “Talk to your pediatrician. The evidence on hepatitis B vaccination is clear, and the stakes for children are too high to compromise.”