Hepatitis B Cases Could Surge Under New Vaccine Guidelines, Study Finds

In the U.S., hepatitis B vaccination became routinely recommended for all infants in 1991; later guidance specified that the first dose should happen within 24 hours of birth. However, in Dec. 2025, the U.S. Centers for Disease Control and Prevention (CDC) under the Trump Administration moved to cease recommending this practice for babies born to mothers who test negative, instead advising a shared decision-making model where parents and clinicians decide together what is medically appropriate: a dose shortly after birth, or a first dose "no earlier than 2 months of age." (For babies born to mothers who test positive or whose status is unknown, the CDC continues to recommend a dose shortly after birth.)A new study, published today in Annals of Internal Medicine, uses computer modeling to simulate the hepatitis B infection status of an entire year’s worth of children born in the U.S. under the new recommendations over their first 20 years of life. The researchers find that if only about 26% of children are vaccinated—an estimate of what would occur under shared decision-making—chronic hepatitis B cases would rise by 225%.When should kids get the first dose of hepatitis B vaccine? “I...