Hepatitis B birth-dose rates dropped before CDC ended decision

WASHINGTON: A recent study shows that hepatitis B vaccination rates in newborn babies in the U.S. had already been going down for more than two years before the Centres for Disease Control and Prevention (CDC) officially stopped recommending the vaccine at birth in December 2025.

The study, published in JAMA, looked at health records from Epic Systems, covering over 12 million babies born between 2017 and 2025. It found that vaccination rates (within 30 days of birth) increased from 67.5 per cent in 2017 to a peak of 83.5 per cent in February 2023. After that, the numbers started falling, reaching 73.2 per cent by August 2025.

Researchers said this decline started before the policy change and matched a rise in public debates about vaccines around mid-2023. Reasons may include ongoing vaccine hesitancy after COVID-19 and popular discussions like an episode of The Joe Rogan Experience featuring Robert F Kennedy Jr, who is known for criticising some vaccine policies.

Hepatitis B is a serious disease that affects the liver and can lead to liver cancer. While most adults recover on their own, over 90 per cent of infected infants and up to 50 per cent of young children develop long-term infection. Since the birth-dose vaccine was introduced in 1991, it has reduced hepatitis B infections in children by 90–99 per cent in the US.

Dr Joshua Rothman from the University of California, San Diego, who led the study, warned that if vaccination rates keep dropping, infections in babies and children could rise again. He called the birth dose a “safety net” because it protects babies in cases where the mother’s infection is missed, there is exposure at home, or follow-up care is delayed.

In the past, vaccination rates had increased a lot—from about 21 per cent in 2002 to over 83 per cent in early 2023, after stronger recommendations to give the vaccine before babies leave the hospital.

In December 2025, under Health Secretary Robert F. Kennedy Jr., the CDC’s Advisory Committee on Immunisation Practices (ACIP) voted 8–3 to end the routine birth-dose recommendation for babies whose mothers test negative. Now, parents and doctors decide together whether to give the vaccine, and if given, it is usually delayed until at least 2 months of age. However, babies born to infected mothers (or when the mother’s status is unknown) must still receive the vaccine and immunoglobulin within 12–24 hours of birth.

The CDC quickly accepted this change. However, many pediatric experts have criticised it, saying it could undo years of progress, especially since there is no new evidence that the vaccine is unsafe. They also point out that the birth dose helps cover real-life gaps in testing and follow-up care.

So far, there is no sign that infections are increasing, but experts say it is important to keep monitoring the situation closely.