New moms and their babies will likely see a change in preventative treatment after they give birth, thanks to a decision by a federal vaccine panel that weakens longstanding guidance on the hepatitis B vaccine.
For years, hospitals and birthing centers have encouraged parents to give their babies three things soon after their children’s birth – the first dose of hepatitis B vaccine, a shot of vitamin K and an antibacterial eye ointment – as part of a practice often called “3 at Birth.”
But the Advisory Committee on Immunization Practices, a board that Health Secretary Robert F. Kennedy Jr. overhauled by adding vaccine skeptics, says only babies born to moms who test positive for hepatitis B should receive the shot at birth. They say other moms should speak with their doctors about the vaccine, advice that experts say will lead to many babies receiving only two treatments at birth.
The panel said babies born to mothers who have not tested positive for hepatitis B should not get the first hepatitis B vaccine until they are at least two months old. The panel did not explain the rationale for two months being the appropriate interval to wait. Additionally, because the current vaccine course requires three shots, the panel recommended babies take a blood test to determine if the first shot provided enough antibodies to protect against the disease before receiving a second dose.
Dr. Jennifer Lincoln, an obstetrician and gynecologist who works in an Oregon hospital, said the new advice means that a nurse at a hospital might tell a new mom, “You tested negative, and you should talk to your health care professional before you decide whether or not (your baby) should receive this series.”
Lincoln said 15% of pregnant women don’t get any testing before delivery, so they may not know in advance if they have hepatitis B. Women who do get prenatal care are tested early in pregnancy, she said, and could contract the disease later. She said that’s risky when you’re dealing with a disease that is 100 times more infectious than HIV.
“We’re going to end up with Swiss cheese holes for sure,” she said.
Certified medical assistant Yvette Garcia draws a dose of the mpox vaccine for a patient at DAP Health in Palm Springs, Calif., Saturday, Sept. 10, 2022.
Rationale behind the hep B shot advice
The panel’s recommendation does not have the full force of a mandate from the Centers for Disease Control and Prevention. But it nonetheless comes from a powerful national voice on vaccine safety, leaving doctors to wonder whether the government will further retreat from endorsing the vaccine. The nation’s public health agency has recommended the vaccine universally since 1991.
The CDC said in a news release that the U.S. has seen a decline in cases of hepatitis B, which can cause liver disease and death, since 1985. But while most doctors attribute this to the previous universal vaccine recommendation, the agency provided an alternate theory.
The agency attributed the drop to better screening before blood transfusions, needle exchange programs and better dialysis practices. Additionally, the CDC said less than 1% of babies are born to moms with the antigen that could give their baby hepatitis B, and most of those moms are immigrants from countries where the disease is widespread.
Aaron Siri presents during a meeting of the Advisory Committee on Immunization Practices (ACIP) to discuss recommendations for the childhood vaccine schedule at the Centers for Disease Control and Prevention in Atlanta, Georgia, U.S., December 5, 2025. REUTERS/Alyssa Pointer
“The American people have benefited from the committee’s well-informed, rigorous discussion about the appropriateness of a vaccination in the first few hours of life,” said Jim O’Neill, the CDC’s acting director.
Dr. Sandra Adamson Fryhofer, a trustee of the American Medical Association, said in a statement that the new advice is not based on scientific evidence or data and is instead “reckless and undermines decades of public confidence in a proven, lifesaving vaccine.”
The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, along with several other medical groups, said the new advice “will lead to more childhood Hepatitis B infections, will lead to more chronic infections that will follow patients into adulthood, and will complicate vaccine access for children.”
Doctors’ appointments could change
Dr. Heidi Appel, pediatrician and member of the Committee to Protect Health Care, said pediatricians still recommend that all newborns receive the vaccine.
But she said fewer babies will likely be vaccinated because some parents will be confused by the new advice. Even parents who plan to get the shot for their baby at a future appointment may need time to find a pediatrician, or life may get in the way of getting the new baby to the office, she said.
“People don’t always make their one-month appointment, and one month becomes two months, becomes three months,” Appel said.
Lincoln, from Oregon, agreed. She said she delayed getting her firstborn’s first hepatitis B shot for about a week because she felt uncomfortable with her son getting a shot so early in life, something that perplexed her pediatrician husband. But she said she knew she and her husband didn’t have the disease, and they would bring the baby to the pediatrician quickly.
Granger rests with his parents Nick and Stephanie Stancombe, Wednesday, Jan. 11, 2023 in their Carmel home. The newborn was one of the first babies to be born in Indianapolis in 2023.
While she was able to make a nuanced, personal choice, Lincoln said not all new parents have the same level of access to testing or pediatricians, and public health agencies need to make recommendations for all parents.
“These recommendations today are not based in science and are going to confuse parents and the most vulnerable, who are people who may not have high health literacy,” Lincoln said. She said many may assume the vaccine isn’t safe, which it is.
Appel recommended that parents use the American Academy of Pediatrics website to get reliable information about the vaccine. She also said parents should choose their child’s pediatrician early and meet with the doctor before the baby is born.
“Talk to them about vaccines, their policies and things like that,” she said. “Learn about it. That’s what we’re here for.”
This article originally appeared on USA TODAY: Which newborns get a hep B vaccine? What RFK Jr. panel’s ruling means.
