Data affirming the safety and efficacy of the current U.S. policy of worldwide hepatitis B vaccination for newborns is bolstering federal health officials as they navigate calls for a policy shift, according to a new analysis published Monday. The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) are defending the decades-old practice amid increasing scrutiny from some physicians and parent groups who advocate for delaying vaccination or testing infants for infection before administering the shot.
The analysis, published in Pediatrics, reviewed decades of data and found no evidence to support altering the current approach. Maintaining universal vaccination, researchers concluded, remains the most effective way to prevent chronic hepatitis B infection, liver disease, and liver cancer, particularly in vulnerable populations. The debate centers on whether to move toward a “test-then-vaccinate” strategy,mirroring practices in some other countries,but experts warn such a change could lead to increased rates of infection and disparities in care.
The CDC recommends all newborns receive the hepatitis B vaccine within 24 hours of birth. This policy, initially implemented in the early 1990s, dramatically reduced the incidence of acute and chronic hepatitis B infections in the U.S. According to CDC data, the rate of chronic hepatitis B infection among children decreased from 1.5% in the 1980s to less than 0.5% today.
“The data are very clear: universal vaccination is working,” said Dr. Litjen Tan, a senior scientist at the Immunization Action Coalition, who was not involved in the Pediatrics analysis. “Any move away from this strategy risks reversing the progress we’ve made and could disproportionately harm communities already facing health inequities.”
Concerns about the vaccine’s safety and necessity have been fueled by online misinformation and a growing “natural immunity” movement. Proponents of delaying vaccination argue that newborns have a low risk of infection and that testing before vaccination would avoid unnecessary shots.However, researchers point out that testing is not foolproof and can miss early infections. Furthermore, delaying vaccination leaves infants vulnerable during the brief window when they are most susceptible to severe illness if infected.
The AAP issued a policy statement reaffirming its support for the current vaccination schedule. “We continue to believe that universal hepatitis B vaccination is the best way to protect all infants from this serious disease,” said Dr. Flor Munoz,chair of the AAP Committee on Infectious Diseases. The CDC is expected to address the concerns further in upcoming meetings and guidance updates, but officials have indicated they remain committed to the current policy based on the available evidence.
