On Dec. 5, 2025, the West Coast Health Alliance (WCHA) announced that it strongly supports that hepatitis B vaccination continue to be routinely offered to all newborns, with the first dose of the vaccine given within 24 hours of birth for newborns weighing at least 2,000 grams (4 pounds, 7 ounces), followed by completion of the vaccine series.

This recommendation aligns with trusted national medical organizations including the American Academy of Pediatrics​, the American College of Obstetricians and Gynecologists​, and the Infectious Diseases Society of America.​

The Advisory Committee on Immunization Practices has voted to end the universal recommendation for hepatitis B vaccination for all infants at birth—a strategy that has reduced pediatric hepatitis B infections in the United States by 99 percent. The ACIP also voted that parents should consult their provider regarding blood tests following each dose of the vaccine series. There was no credible evidence presented to support either of these changes. Delaying the birth dose of hepatitis B vaccine and using blood tests to guide vaccination will lead to more children and adults developing preventable liver disease and liver cancer with no evidence of a safety benefit.​

A review by the Vaccine Integrity Project found that the vaccine is safe regardless of when it is given, and there are no safety benefits to delaying the first dose. Delaying the first dose increases the risk of infection and jeopardizes completion of the full vaccine series, which is required for long-lasting protection. Many with chronic hepatitis B do not know they are infected, and infants may unknowingly be infected by household and other contacts following birth. The birth dose acts as a critical safety net to protect newborns from infection. It is not known for how long and how strongly children are protected against hepatitis B infection if they don’t receive a complete vaccine series.

The unproven recommendation to obtain blood tests to guide the number of hepatitis B shots will subject infants to painful and unnecessary blood draws, increase health care costs, delay immunization, and risks decreased protection against infection. Completion of the vaccine series has been shown to offer the best protection. ​

Hepatitis B is a highly infectious virus that attacks the liver and can cause chronic liver disease, liver cancer, liver failure, and death. It spreads easily — even without visible blood or body fluids and can survive on surfaces for up to seven days. Before the United States adopted a recommendation for universal infant hepatitis B vaccination in 1991, thousands of children were infected each year — both at birth and during childhood. Infants and young children are especially vulnerable: up to 90 percent of infants infected at birth develop chronic infection and 25 percent of infected children die prematurely from hepatitis-related disease. 

The hepatitis B vaccine is effective, well tolerated, and decades of global data support its safety. It should continue to be offered to all parents at birth. Universal vaccination of newborns within 24 hours of birth, followed by completion of the vaccination series, is essential to protecting infants and young children, who are at greatest risk from complications from hepatitis B.