US vaccine advisers say not all babies need a hepatitis B shot at birth
[December 06, 2025]
By MIKE STOBBE
NEW YORK (AP) — A federal vaccine advisory committee voted on Friday to
end the longstanding recommendation that all U.S. babies get the
hepatitis B vaccine on the day they’re born.
A loud chorus of medical and public health leaders decried the actions
of the panel, whose current members were all appointed by U.S. Health
Secretary Robert F. Kennedy Jr. — a leading anti-vaccine activist before
this year becoming the nation’s top health official.
“This is the group that can’t shoot straight,” said Dr. William
Schaffner, a Vanderbilt University vaccine expert who for decades has
been involved with the Advisory Committee on Immunization Practices and
its workgroups.
Several medical societies and state health departments said they would
continue to recommend them. While people may have to check their
policies, the trade group AHIP, formerly known as America’s Health
Insurance Plans, said its members still will cover the birth dose of the
hepatitis B vaccine.
For decades, the government has advised that all babies be vaccinated
against the liver infection right after birth. The shots are widely
considered to be a public health success for preventing thousands of
illnesses.
But Kennedy’s advisory committee decided to recommend the birth dose
only for babies whose mothers test positive, and in cases where the mom
wasn’t tested.
For other babies, it will be up to the parents and their doctors to
decide if a birth dose is appropriate. The committee voted 8-3 to
suggest that when a family elects to wait, then the vaccination series
should begin when the child is 2 months old.
President Donald Trump posted a message late Friday calling the vote a
“very good decision.”
The acting director of the Centers for Disease Control and Prevention,
Jim O’Neill, is expected to decide later whether to accept the
committee’s recommendation.
The decision marks a return to a health strategy abandoned more than
three decades ago
Asked why the newly-appointed committee moved quickly to reexamine the
recommendation, committee member Vicky Pebsworth on Thursday cited
“pressure from stakeholder groups,” without naming them.
Committee members said the risk of infection for most babies is very low
and that earlier research that found the shots were safe for infants was
inadequate.
They also worried that in many cases, doctors and nurses don’t have full
conversations with parents about the pros and cons of the birth-dose
vaccination.
The committee members voiced interest in hearing the input from public
health and medical professionals, but chose to ignore the experts’
repeated pleas to leave the recommendations alone.
The committee gives advice to the director of the Centers for Disease
Control and Prevention on how approved vaccines should be used. CDC
directors almost always adopted the committee’s recommendations, which
were widely heeded by doctors and guide vaccination programs. But the
agency currently has no director, leaving acting director O’Neill to
decide.
In June, Kennedy fired the entire 17-member panel earlier this year and
replaced it with a group that includes several anti-vaccine voices.
Hepatitis B and delaying birth doses
Hepatitis B is a serious liver infection that, for most people, lasts
less than six months. But for some, especially infants and children, it
can become a long-lasting problem that can lead to liver failure, liver
cancer and scarring called cirrhosis.
In adults, the virus is spread through sex or through sharing needles
during injection drug use. But it can also be passed from an infected
mother to a baby.
In 1991, the committee recommended an initial dose of hepatitis B
vaccine at birth. Experts say quick immunization is crucial to prevent
infection from taking root. And, indeed, cases in children have
plummeted.
Still, several members of Kennedy’s committee voiced discomfort with
vaccinating all newborns. They argued that past safety studies of the
vaccine in newborns were limited and it’s possible that larger,
long-term studies could uncover a problem with the birth dose.
But two members said they saw no documented evidence of harm from the
birth doses and suggested concern was based on speculation.
Three panel members asked about the scientific basis for saying that the
first dose could be delayed for two months for many babies.
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The CDC Advisory Committee on Immunization Practices meets in
Atlanta on Friday, Dec. 5, 2025 to consider changes in hepatitis B
vaccine recommendations for infants. (AP Photo/Ben Gray)
 “This is unconscionable,” said
committee member Dr. Joseph Hibbeln, who repeatedly voiced
opposition to the proposal during the sometimes-heated two-day
meeting.
The committee’s chair, Dr. Kirk Milhoan, said two months was chosen
as a point where infants had matured beyond the neonatal stage.
Hibbeln countered that there was no data presented that two months
is an appropriate cut-off.
Dr. Cody Meissner also questioned a second proposal — which passed
6-4 — that said parents consider talking to pediatricians about
blood tests meant to measure whether hep B shots have created
protective antibodies.
Such testing is not standard pediatric practice after vaccination.
Proponents said it could be a new way to see if fewer shots are
adequate.
A CDC hepatitis expert, Adam Langer, said results could vary from
child to child and would be an erratic way to assess if fewer doses
work. He also noted there’s no good evidence that three shots pose
harm to kids.
Meissner attacked the proposal, saying the language “is kind of
making things up.”
Health experts say this could ‘make America sicker’
Health experts have noted Kennedy’s hand-picked committee is focused
on the pros and cons of shots for the individual getting vaccinated,
and has turned away from seeing vaccinations as a way to stop the
spread of preventable diseases among the public.
The second proposal “is right at the center of this paradox,” said
committee member Dr. Robert Malone.
Some observers criticized the meeting, noting recent changes in how
they are conducted. CDC scientists no longer present vaccine safety
and effectiveness data to the committee. Instead, people who have
been prominent voices in anti-vaccine circles were given those
slots.
The committee “is no longer a legitimate scientific body,” said
Elizabeth Jacobs, a member of Defend Public Health, an advocacy
group of researchers and others that has opposed Trump
administration health policies. She described the meeting this week
as “an epidemiological crime scene.”
Republican Sen. Bill Cassidy, a liver doctor who chairs the Senate
health committee, called the committee’s vote on the hepatitis B
vaccine “a mistake."
“This makes America sicker," he said, in a post on social media.
The committee heard a 90-minute presentation from Aaron Siri, a
lawyer who has worked with Kennedy on vaccine litigation. He ended
by saying that he believes there should no ACIP vaccine
recommendations at all.
In a lengthy response, Meissner said, “What you have said is a
terrible, terrible distortion of all the facts." He ended by saying
Siri should not have been invited.
The meeting’s organizers said they invited Siri as well as a few
vaccine researchers — who have been vocal defenders of immunizations
— to discuss the vaccine schedule. They named two: Dr. Peter Hotez,
who said he declined, and Dr. Paul Offit, who said he didn't
remember being asked but would have declined anyway.
Hotez, of the Texas Children’s Hospital in Houston, declined to
present before the group “because ACIP appears to have shifted its
mission away from science and evidence-based medicine,” he said in
an email to The Associated Press.
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AP writers Ali Swenson in New York, Laura Ungar in Louisville,
Kentucky, and Lauran Neergaard in Washington, D.C., contributed to
this report.
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