December 11, 2025
Last week CDC’s Advisory Committee on Immunization Practices (ACIP) voted on drastic changes to the childhood immunization schedule for prevention of hepatitis B, a serious and costly infection that can result in liver disease, liver cancer, and death. If ACIP’s new recommendations are adopted by CDC, they threaten to reverse decades of progress and foster confusion and uncertainty among parents.
For the first time in over thirty years, CDC would no longer endorse immunizing all children against hepatitis B, calling instead for “individual decision-making” between patients and providers. This shocking abandonment of longstanding medical consensus places a tremendous burden on parents, who can no longer look to ACIP for clear guidance to inform them on how best to protect their children from preventable disease. Instead, ACIP has abdicated its responsibility to synthesize the best available evidence, pushing that responsibility onto parents and their pediatricians. This withdrawal of the recommendation for universal childhood immunization marks a stark departure from standard public health practice in similar countries; despite ACIP’s repeated invocation of other nation’s vaccine policies, 90% of European countries (27 out of 30) maintain clear and unambiguous recommendations that all children receive hepatitis B vaccination.
ACIP now instructs parents to roll the dice on “deciding when or if to give the HBV vaccine” to their children, advising only that they ” should consider vaccine benefits, vaccine risks, and infection risks.” ACIP places a tremendous onus on individual parents who simply have no plausible or reliable way to predict their child’s chances of future exposure to hepatitis B, whether in childhood, adolescence, or adulthood. By nullifying the straightforward and unambiguous guidance that all children should be immunized, ACIP turns childhood vaccination into a guessing game fraught with doubt and laden with guilt for parents about whether they’re choosing wisely.
ACIP compounded this rash vote by further suggesting “post-vaccination anti-HBs serology testing” after each dose of HBV vaccine, implying that the full series of doses may not be beneficial or desirable. This practice has never been evaluated in children nor been adopted anywhere in the United States or the rest of the world, and poses considerable costs and implementation challenges. By encouraging parents to adopt an unproven practice that may leave their children with insufficient protection from hepatitis B, ACIP does a huge disservice to its mission and credibility.
ACIP’s review of childhood hepatitis B vaccination ultimately relied on a distorted and disingenuous misrepresentation of the abundant evidence supporting universal immunization, dismissing data demonstrating high efficacy and favorable safety in favor of unproven speculation and baseless fearmongering. Decades of global experience with hepatitis B immunization involving hundreds of millions of vaccine doses administered provide compelling data on the overall safety of routine childhood immunization, and no data reviewed by ACIP contradicts this impressive safety record. As some committee members and liaisons repeatedly stated, the ACIP workgroup tasked with reviewing these recommendations failed to provide a substantive, good faith justification for altering well-established practices. Despite committee members’ frequently avowed concerns with restoring confidence in the childhood immunization schedule, ACIP ultimately squandered an opportunity to reassure parents by reaffirming the rationale and support for protecting all children from hepatitis B-related liver disease. These new recommendations will most likely instill confusion, erode confidence, dampen vaccine uptake, and result in hundreds of preventable infections among vulnerable children.
NVHR urges providers, parents, and payers to rely on the evidence-based recommendation for universal hepatitis B birth dose vaccination from reliable professional societies and experts NVHR further encourages all stakeholders, including policymakers and elected officials, to remain vigilant against further erosion of progress towards eliminating hepatitis B as well as the integrity of the overall childhood immunization schedule. NVHR commits to working with partners and across our network to champion and defend effective strategies to eliminate hepatitis B as a public health threat in the United States.
For further information and responses, consult these trusted sources:
Statement from American Academy of Pediatrics (AAP)
Statement from Hepatitis B Foundation (HBF)
Statement from Vaccinate Your Family (VYF)
Statement from American Association for the Study of Liver Diseases (AASLD)