Birth doses of hepatitis B vaccine on decline in US before CDC scrapped recommendation

Use ​of hepatitis B vaccines in U.S. newborns was declining well ‌before ​the Centers for Disease Control and Prevention scrapped a longstanding broad recommendation for the shots in December, researchers said on Monday.

Between 2023 and 2025, rates of hepatitis B vaccination within 30 days after birth dropped more than 10 percentage points, they reported in ‌JAMA. Until then, use of the shots in newborns had been climbing for decades as the U.S. government backed the first shot shortly after birth. Under Health Secretary Robert F. Kennedy Jr., the CDC dropped the recommendation unless the mother has the virus or her status is unknown.

The hepatitis B virus attacks the liver and is the leading cause of liver cancer ‌worldwide. In most adults, the infection resolves on its own. But it becomes chronic in more than 90% of infants and in up to 50% of young ‌children who become infected. Public health data shows the vaccine reduced hepatitis B infections in U.S. children by nearly 90% after it was recommended for newborns in 1991.

“If the rates of vaccination decline too significantly, we may see a resurgence in hepatitis B infections in infants and children,” said study leader Dr. Joshua Rothman, a pediatrician at the University of California, San Diego. JULY 2023 TURNING POINT

The beginning of the decline in July ⁠of 2023 ​coincided with an uptick in public discourse and ⁠media coverage of childhood vaccination, according to the report. That period included a widely circulated episode of the Joe Rogan Experience podcast featuring a discussion with long-time vaccine critic Kennedy, the researchers noted.

Kennedy, President Donald Trump, and ⁠other public figures have claimed - contrary to scientific evidence - that childhood vaccines are a cause of autism. The government has dropped recommendations for six childhood vaccines in the past year. Between 2002 – three years ​before U.S. guidelines first advised that medically stable newborns should receive the vaccine before hospital discharge – and 2023, birth-dose HBV vaccination rates rose from about 21% to ⁠83.5%, the report says.

By August 2025, that rate was down to 73.2%, according to the researchers’ analysis of data from Epic Systems Corp on more than 12 million babies born between 2017 and 2025. In December 2025, ⁠an ​advisory panel appointed by Kennedy scrapped the decades-old advice. When mothers test negative, parents should decide with their doctors when, or even if, their children should receive any hepatitis B vaccines, the panel said.

The advisers, many of whom share Kennedy's anti-vaccine views, provided no evidence of new harms from the shot. They argued that vaccination was too broad ⁠compared to the risk of infection. The CDC, also overseen by Kennedy, quickly endorsed that view. Disease experts have warned the policy change could erode decades of public health progress.

Rothman ⁠said he is not aware yet of ⁠studies showing an increase in cases. “The reason pediatricians and the American Academy of Pediatrics still recommend the birth dose for all newborns is that it serves as a safety net,” Rothman said.

“If the maternal test ends up being a false negative, if there’s an ‌unexpected household or caregiver exposure, ‌or if the infant’s follow-up is delayed, this birth dose provides early protection.”