The US Centers for Disease Control and Prevention (CDC) has ended a long-standing recommendation that all newborns receive the hepatitis B vaccine, marking an abrupt shift from 30 years of established medical guidance. The change follows a vote by health secretary Robert F Kennedy Jr’s vaccine advisory panel, which advised that the birth dose should only be given to infants whose mothers test positive for hepatitis B or whose status is unknown.
The CDC will now advise parents to consult a healthcare provider to decide whether to vaccinate infants born to hepatitis B-negative mothers. “We are restoring the balance of informed consent to parents whose newborns face little risk of contracting hepatitis B,” said acting CDC director Jim O’Neill in a statement. If parents choose not to vaccinate at birth but later decide it is warranted, the agency recommends waiting at least two months for the first dose.
Experts have voiced concern about the policy shift, which the CDC describes as “individual-based decision making”. Michaela Jackson, programme director of prevention policy at the Hepatitis B Foundation, warned it could lead to an increase in preventable infections among children. “Parents are not going to know who to trust any longer,” she said, adding that the change could create barriers to access as CDC recommendations influence insurance coverage and clinical guidance.
Hepatitis B can cause serious liver disease and is spread through blood, semen, or other body fluids. Infections in the US have fallen nearly 90% from 9.6 per 100,000 people before widespread vaccination in 1982 to about one per 100,000 in 2018. Critics fear the new policy could expose more children to the virus and lead to more families opting out.
Dr Emily Landon, an infectious diseases expert at the University of Chicago Medicine, criticised the decision. “This recommendation is ignoring the science,” she said. “The fact that the acting director of the CDC would sign on to this just continues to reinforce that they are no longer committed to science-based recommendations for improving health.”
