Delayed hepatitis B dose may raise child infections 83%

A U.S. modeling study published Oct. 20 in Annals of Internal Medicine projected chronic hepatitis B infections among children could rise 83% to 225% if newborn vaccination uptake falls.

Evidence grade: Early (small, animal, cell or preprint), because the figures are model-based projections rather than observed outcomes. The study compared shared decision making with universal birth-dose vaccination, under which 232,000 young adults were projected to remain susceptible by age 20.

Healthline News reported Oct. 21 that the Centers for Disease Control and Prevention ended its universal birth-dose recommendation in December 2025 for infants whose mothers test negative for hepatitis B surface antigen, known as HBsAg. The CDC shifted those infants to individual-based clinical decision making.

The CDC, which is overseen by the Department of Health and Human Services, said after reviewing evidence that newborns “face little risk of contracting hepatitis,” according to Healthline News. The policy change followed an 8 to 3 vote by the Advisory Committee on Immunization Practices.

Graham Tse, pediatrician and chief medical officer of MemorialCare Miller Children’s & Women’s Hospital in Long Beach, Calif., told Healthline News: “There has been no new data or evidence presented or uncovered to support delaying the newborn dose of hepatitis B.”

Hepatitis B is a viral liver infection. Healthline News reported that up to 90% of infants infected during their first year develop chronic infection, which can lead over time to cirrhosis, liver failure or liver cancer.

The modeling study projected a 19% increase in chronic hepatitis B infections among infants if the first vaccine dose were delayed until 2 months under one scenario. Under shared decision making with lower uptake, the projected increase ranged from 83% to 225%, compared with universal birth-dose vaccination.

The same study estimated that as many as 1.8 million young adults could remain susceptible to hepatitis B by age 20 under shared decision making. Healthline News also cited a JAMA Pediatrics study published in late April that projected hundreds of additional chronic infections annually if the birth dose were delayed or omitted.

The study cannot show how infection rates have changed since the CDC policy shift, because its numbers are projections. Actual outcomes will depend on vaccination rates and other factors.

The updated CDC approach does not apply the same way to all newborns. Healthline News reported that infants born to mothers who test positive for hepatitis B or whose infection status is unknown should still receive the hepatitis B vaccine and hepatitis B immune globulin within 12 hours of birth under the updated guidelines.

The American Academy of Pediatrics continues to recommend a universal hepatitis B vaccine dose within 24 hours of birth, followed by additional doses during infancy. That leaves parents and clinicians with conflicting institutional guidance after the CDC’s December 2025 change.

Source: Healthline News article, Oct. 21, 2026.

Atlas360 reports health research and does not provide medical advice.