type: timeline_event The CDC's Advisory Committee on Immunization Practices (ACIP) votes 8-3 to end the universal recommendation that all newborns receive hepatitis B vaccination at birth, reversing a 34-year policy that reduced pediatric hepatitis B infections by 99%. The committee, entirely reconstituted by HHS Secretary Robert F. Kennedy Jr. after he fired all 17 sitting members in June 2025, recommends "individual-based decision-making" for infants born to mothers who test negative for the virus, with delayed vaccination until at least 2 months of age.
The policy change represents the most significant rollback of childhood vaccination recommendations in modern U.S. public health history. Before universal birth-dose vaccination began in 1991, approximately 20,000 newborns contracted hepatitis B annually; that number has fallen to fewer than 20 per year. Medical data shows that 90% of infants infected with hepatitis B develop chronic infection, with approximately 25% dying prematurely from liver complications including cirrhosis and liver cancer.
The vote provokes unprecedented opposition from the medical community. American Academy of Pediatrics President Dr. Susan Kressly states the change "makes children in America less safe" and calls it "irresponsible and purposely misleading guidance" that will "lead to more hepatitis B infections in infants and children." The AAP immediately instructs its 67,000 members to ignore ACIP's recommendation and continue vaccinating all newborns. Dr. Cody Meissner, the only panel member with prior ACIP service who voted against the change, warns: "We are doing harm by changing this wording."
Additional medical organizations denouncing the change include the American College of Physicians, the Infectious Diseases Society of America, the American Association of Immunologists, and the Hepatitis B Foundation. Dr. Flor Munoz of IDSA asks: "How can this committee justify removing a well established, successful and safe prevention strategy?" Dr. Joseph Hibbeln criticizes that "no rational science has been presented" to justify the change. Dr. Stephen Patrick, a neonatologist at Children's Hospital of Atlanta, states: "For the first time in my career, I am deeply concerned that I cannot fully rely on the CDC's recommendations."
The committee's stated rationale contradicts available evidence. PBS NewsHour fact-checking reveals that ACIP's claim that the U.S. is an "outlier" in recommending birth-dose vaccination is false: of 194 WHO member states, 116 recommend universal hepatitis B birth-dose vaccination. Committee members claim the change primarily affects "low-risk" populations, but the CDC estimates that approximately half of the 640,000 chronically infected American adults don't know they're infected, making exposure risk assessment unreliable. A 2019 study found that 57.9% of hepatitis B cases among newborns involved non-U.S.-born mothers from high-endemicity countries, but no enhanced screening measures were proposed to identify these cases.
The recommendation requires approval from acting CDC Director Jim O'Neill, a former investment executive without medical background, or from HHS Secretary Kennedy before becoming official policy. Senator Bill Cassidy urges O'Neill to reject the vote, calling it "a mistake." O'Neill comments that "The American people have benefited from the committee's well-informed, rigorous discussion," signaling likely approval.
The policy change reflects Kennedy's longstanding anti-vaccine ideology. As a vaccine skeptic who has promoted debunked theories linking vaccines to autism, Kennedy personally selected every ACIP member after firing the previous committee. The reconstituted panel includes individuals who have "largely expressed skepticism of vaccines," according to NBC News. No new safety concerns, effectiveness issues, or changes in hepatitis B risk prompted the policy review; panel members cite parental concerns and the fact that "it's been a long time" since the recommendation was last reviewed.
Public health experts warn the change will reverse decades of progress. CDC analysis estimates that hepatitis B vaccination prevented over 6 million infections and nearly 1 million hospitalizations among children born between 1994-2023. Acute hepatitis B cases among children dropped 99% between 1990-2019. The American Association of Immunologists warns that "even a modest delay could result in a substantial increase in preventable chronic infections, liver cancers, and deaths." Dr. Sean O'Leary, chair of AAP's Committee on Infectious Diseases, emphasizes: "This is a situation where one missed case is too many."
The hepatitis B vaccine has "one of the most well established safety records of any vaccine," according to the AAP. The virus spreads from mother to child during delivery and through microscopic blood exposure in everyday interactions. Infected infants face lifetime consequences: chronic hepatitis B infection leads to severe liver disease, cirrhosis, liver cancer, and premature death in approximately one-quarter of cases. Unlike adults, infants' immune systems cannot effectively clear the infection, resulting in the 90% chronic infection rate.
Multiple states and medical organizations announce they will not follow the new guidance. New York State's Department of Health declares it will continue recommending birth-dose vaccination. The AAP's directive to ignore ACIP represents an extraordinary breach in the traditional relationship between federal health authorities and medical professional organizations, reflecting deep concern about political interference in public health decision-making.
The vote marks Kennedy's most extreme public health rollback since taking office as HHS Secretary, fundamentally undermining the CDC's credibility and the integrity of the vaccine advisory process. By reconstituting ACIP with vaccine skeptics and overturning evidence-based policies without scientific justification, the decision prioritizes anti-vaccine ideology over child safety and represents a dangerous precedent for politically-motivated erosion of public health protections.