Health Care

CDC move to stop recommending hepatitis B vaccine could lead to hundreds of infections: research

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by Nathaniel Weixel - 04/27/26 5:34 PM ET

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by Nathaniel Weixel - 04/27/26 5:34 PM ET

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The decision by the Center for Disease Control and Prevention to stop recommending giving infants a dose of the hepatitis B vaccine within 24 hours after birth is likely to lead to hundreds of more infections, worse health outcomes and millions of dollars in higher costs, according to new research published Monday in JAMA Pediatrics.

The CDC in December approved the change to longstanding practice following a vote by health secretary Robert F. Kennedy Jr.’s vaccine advisory panel.

The agency now advises women who test negative for the virus to consult health care providers about whether their babies should get their first doses within 24 hours of birth. Those mothers are recommended, in discussion with a medical provider, to delay the initial dose to at least 2 months of age.

The recommendation drew swift pushback from the medical community for upending 30 years of established guidance and practice. Doctors and infectious disease experts said there is no evidence to back delaying the vaccine. They worry the new guidance will bring a resurgence of the virus.

The U.S. has been safely giving the hepatitis B vaccine at birth since 1991, a move that has been credited with nearly eliminating the disease in young children. Cases of hepatitis B infection in children have declined by 99 percent.

The researchers used economic models to estimate the impact of changes to the vaccine recommendation. They found the longer the delay, the higher the cost in human life and health care, with costs ranging from $16 million to $370 million depending on the age of first vaccination and adherence to vaccination schedules.

One analysis found delaying the hepatitis B series by 2 months among children born in a single year to parents who tested negative for the virus would increase lifetime healthcare costs by $16.4 million.

If vaccination was delayed by 7 months, it would cost an additional $19.8 million.

The researchers noted the estimates were conservative because they assumed perfect adherence to the 3-dose vaccine series. They also didn’t include the increasing risk of children getting a hepatitis B infection from members of their household or community, which could happen if the number of people with HBV infections increases.

Hepatitis B can be passed from mother to child during delivery, and not all pregnant women get screened for it. There is no cure.

All projections showed that, in unvaccinated groups, more individuals progressed to chronic infection or serious complications like cirrhosis and liver cancer.

The advisory committee’s recommendation on hepatitis B vaccines came following a discussion rife with misinformation and cherry-picked data promoted by people with a history of vaccine skepticism.

The recommendation was, in part, based on low infections. But the low incidence of hepatitis B infections in the United States is a direct result of the successful vaccination programs.

An editorial accompanying the study’s recommendations noted that birth-dose hepatitis B vaccination rates in the U.S. were already decreasing even before the panel voted.

Birth-dose hepatitis B vaccination rates peaked at 83.5 percent in February 2023 but have been dropping since, with only 73.2 percent of newborns receiving hepatitis B vaccine by August 2025.

The JAMA editorial said the models would typically have been presented to the ACIP as part of the decision-making process to quantify the anticipated impact of changing the vaccine recommendation on health outcomes and health care costs.

But the committee “did not consider the harms of delaying vaccination,” the editorial said.

The vaccine panel was focused “solely on theoretical safety concerns for infants, despite the absence of safety signals with more than 1 billion doses given worldwide since 1982,” the editorial said.

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