On December 5, 2025, the CDC’s Advisory Committee on Immunization Practices (ACIP) voted 8–3 to recommend shared clinical decision-making for parents considering the hepatitis B vaccine, including the birth dose, for infants born to women who test negative for the virus.
Under this approach, parents and healthcare providers should evaluate vaccine benefits, potential risks, and an infant’s likelihood of exposure before deciding when or whether to begin the hepatitis B vaccine series. For infants who do not receive the birth dose, the ACIP recommends administering the first dose no earlier than two months of age.
ACIP also recommended that parents consult with healthcare providers when determining the need for subsequent hepatitis B doses, including whether to test antibody levels to assess adequate protection.
The updated recommendations maintain coverage across all major payment programs, including the Vaccines for Children Program, Medicaid, Medicare, the Children’s Health Insurance Program, and plans offered through the federal Health Insurance Marketplace. In September 2025, ACIP also voted to recommend hepatitis B testing for all pregnant women, a service already covered by insurers.
The vote followed presentations on hepatitis B disease burden, vaccine safety, and immunization practices in other countries. Data presented to the committee showed a significant decline in hepatitis B cases since 1985, largely due to improved blood screening, dialysis safety, and public health interventions. Presenters also noted that the greatest risk of transmission to newborns remains maternal infection, which affects approximately 0.5% of pregnancies in the U.S.
ACIP recommendations become official once adopted by the CDC director and incorporated into the CDC immunization schedule.