The Centers for Disease Control and Prevention (CDC) announced on December 16, 2025, that it has adopted an individual-based approach to hepatitis B immunization for infants born to mothers who test negative for the virus. Under this new policy, parents and healthcare providers will jointly decide whether and when to administer the hepatitis B vaccine, including the birth dose.
This method, referred to as shared clinical decision-making on the CDC immunization schedule, encourages parents and healthcare professionals to weigh vaccine benefits and risks along with potential infection risks. Factors such as whether a household member has hepatitis B or frequent contact with people from regions where the virus is common should be considered during this process.
The CDC’s Advisory Committee on Immunization Practices (ACIP) recommended these changes, which were approved by Acting Director of the CDC and Deputy Secretary of Health and Human Services Jim O’Neill. The CDC will update both its child immunization schedule and clinical guidance for hepatitis B vaccines in accordance with these recommendations.
“This recommendation reflects ACIP’s rigorous review of the available evidence,” said Acting Director of the CDC and Deputy Secretary of Health and Human Services Jim O'Neill. “We are restoring the balance of informed consent to parents whose newborns face little risk of contracting hepatitis B.”
For infants not receiving the birth dose due to this policy change, it is suggested that their first dose be given no earlier than two months old. The current guidelines remain unchanged for infants born to mothers who are positive for hepatitis B or whose status is unknown; these infants should continue receiving both the recommended birth dose of hepatitis B vaccine and immunoglobulin.
Additionally, the CDC is considering ACIP’s secondary recommendation that parents consult with healthcare providers about serology testing to determine if further doses are needed.
The updated approach ensures continued coverage for hepatitis B vaccination through all payment systems. This includes entitlement programs such as Vaccines for Children Program, Children’s Health Insurance Program, Medicaid, Medicare, as well as insurance plans provided through the federal Health Insurance Marketplace.
