FAQs About the Hepatitis B Vaccination For Babies

The Centers for Disease Control and Prevention (CDC) has reversed its recommendation for administering the hepatitis B vaccine to newborns within 24 hours of birth. The policy change, which is the latest of several controversial shifts within the Department of Health and Human Services, has raised concern among vaccination experts who warn of the long-term potential impacts of questioning the long-accepted efficacy of vaccinations. 

“Rolling back universal hepatitis B vaccination for newborns is far more consequential than it may appear,” said David Dodd, CEO of GeoVax, a vaccine development company. “The newborn dose has been one of the quiet public-health successes of the past generation, its removal risks reversing decades of progress.”

Since 1991, the CDC has recommended hepatitis B vaccination as part of the newborn vaccine schedule, allowing it to be covered by standard insurance policies and administered in the delivery room. The vaccine is highly effective, said Dodd. At the beginning of his career, Dodd was a part of the initial team that measured the prevalence of hepatitis B. Pre-vaccine, 20,000 babies tested positive for the disease annually. That number is about 20 today. 

“[Hepatitis B] leads to various liver diseases, which can lead to cirrhosis of the liver and cancer,” said Dodd. “It’s not something that’s benign that you can just dismiss. It’s very concerning.”

Dodd warns of the long-term consequences of terminating the recommendation for the vaccine, especially for expecting mothers of low socioeconomic status with limited access to prenatal care. 

“I get concerned that thinking that by just simply saying we’re going to encourage the mother to engage with their medical team, and just have discussions, I think that’s very naive,” he said. “Considering and relying on the fact that everybody will have the discussions and engage, not everybody has that opportunity.”

Hepatitis B is one of several vaccines that have lost their federal support under the Secretary of Health and Human Services Robert F. Kennedy Jr. and his appointed staff. In June, the department withdrew its recommendations for the COVID-19 vaccine for small children. In September, the CDC removed recommendations for the MMR vaccine, even after one of the largest outbreaks of measles swept through a largely unvaccinated community in Texas. 

“We know that it’s a very safe vaccine, so it’s not noted for a lot of concerns for distributing it,” he said. “It’s basically a policy decision on how people want decisions to be made.”

What is hepatitis B?

Hepatitis B is a viral infection that can lead to liver disease. When acquired in infancy, it is usually a chronic life-long condition with no cure, but there are antiviral medications that can alleviate symptoms. 

How is it transmitted?

Hepatitis B is a sexually transmitted infection. Common ways adults contract an acute form of the virus are through activities that exchange bodily fluids, like sharing needles, sexual intercourse, or more benign actions like swapping toothbrushes and razors. In these scenarios, the virus can be cleared on its own without the need for medication. Hepatitis B is highly contagious and more easily transmitted than most other STDs. 

During labor and delivery, infants can contract Hepatitis B from their mother through blood in the vaginal canal. When babies contract the infection there is a 90% chance it will become a lifelong chronic disease. 

Will insurance cover it?

Typically, insurance providers follow CDC recommendations on their coverage options. However, in a break from the status quo, most private insurers, as well as Medicare and Medicaid, have announced that they will continue to cover the hepatitis B vaccine without change through 2026. 

How effective is the vaccine?

The hepatitis B vaccine is highly effective, especially when all three doses are properly administered. Starting at birth, then administered a second time at 1 to 2 months old and a final dose between 6 and 18 months. Women who are unvaccinated can also receive the vaccine while pregnant to prevent the disease from spreading to their newborn, although it’s still recommended that all babies, regardless of their mother’s vaccination status, receive the vaccine in the hospital at birth. 

“The fact that we can break that chain of transmission from a mother to a child, and then if that child happens to be a female and becomes a mother someday, now we’ve broken that whole continuous chain,” said Dodd. “It’s concerning that this is a policy that we would pull back on.”

Why is it administered at birth?

Administration at birth prevents any babies from slipping through the cracks when the disease is asymptomatic, or mothers have not had access to proper prenatal care, says Dodd. It is also likely to encourage mothers to finish the vaccination program.

“Many mothers with chronic Hepatitis B are asymptomatic and unaware of their infection. Universal newborn vaccination creates a safety net that protects infants regardless of maternal screening gaps, late prenatal care, or missed diagnoses. Once that first dose is removed, we reintroduce the very vulnerabilities the policy was designed to eliminate. Second, the newborn period is uniquely effective for establishing long-term immunity. Administering the first dose at birth is not just convenient, it is biologically strategic.”

Why did the CDC change its recommendation?

The CDC has progressively changed its recommendations for various vaccines, and medical professionals believe the changes are not necessarily being made in the name of improving public health.

“It’s really very concerning that agenda and decisions are being made more based on political ideology than science,” said the director of Dallas County Health and Human Services, Dr. Philip Huang.