ACIP review of the hepatitis B birth dose vaccination remains a grave concern
After the Sept. 18-19 Advisory Committee on Immunization Practices’ (ACIP) discussion on the hepatitis B vaccine birth dose and decision to table the vote, we remain extremely concerned about the intention of ACIP to revisit and alter this well-established universal hepatitis B vaccine recommendation. Today’s decision avoids, at least temporarily, interruptions toward the elimination of hepatitis B in the U.S. We stand firmly in the knowledge that this recommendation should not be changed.
The success of the hepatitis B vaccine is backed by 40 years of evidence. With 1 billion doses administered globally, and a reduction of 99% in acute infections in children 19 and younger in the U.S., the benefits of the vaccine are irrefutable. Weakening the birth dose recommendation would risk reversing decades of progress and undermines public confidence in a vaccine that prevents a leading cause of liver cancer.
ACIP’s delay in reconsidering the birth dose vaccination provides our organizations and others the opportunity to educate key stakeholders on the importance of the birth dose to infants, their families, and public health. We call upon ACIP to reestablish the CDC’s hepatitis B workgroup for any future reviews of the scientific evidence regarding the hepatitis B vaccine, including the birth dose, and request full transparency as to the processes and frameworks used to evaluate potential alterations to recommendations. The Evidence-to-Recommendation (EtR) Framework is one of our best tools in providing unbiased, transparent data. ACIP workgroups should use EtR for every vaccine under consideration. To be clear: we do not agree with the need to revisit the universal hepatitis B birth dose recommendation. However, all studies used to justify any changes to vaccine recommendations should be held to the highest scientific standards possible.
Rigorous scientific evidence must inform all vaccine recommendations. Anything less leads to confusion and causes opportunities for those most vulnerable to be missed. We sincerely thank our CDC colleagues for presenting the most rigorous data available, and the ACIP liaison members for calling for strong, evidence-based recommendations and a return to the standard EtR Framework that is expected of the ACIP.
Signed Organizations:
Hepatitis B Foundation
American Academy of Pediatrics
American Association for the Study of Liver Diseases
Asian Pacific Islander American Health Forum
Association of Asian Pacific Community Health Organizations
Center for Disease Analysis Foundation
Global Liver Institute
Immunize.org
National Viral Hepatitis Roundtable
9/19/25