Physicians raise concerns about federal hep B vaccine change

Hanna Webster, Pittsburgh Post-Gazette on Dec 11, 2025

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Providers are reeling from a change last week by a federal agency responsible for setting and updating vaccination guidelines for American children and adults.

The Advisory Committee on Immunization Practices, which crafts critical guidelines that the Centers for Disease Control and Prevention then adopts and provides to the public, voted 8-3 on Dec. 5 to loosen the recommendations around giving the hepatitis B vaccine to newborns at birth, shifting a 30-year recommendation toward individual decision-making between families and clinicians for mothers who test negative for the virus. It still recommends vaccination for the babies of those who test positive.

Health and Human Services Secretary Robert F. Kennedy Jr. fired all members of the committee in June and replaced them with a hand-picked panel, many of whom have criticized COVID-19 vaccines, mandates and mRNA technology.

Other medical societies have swiftly responded to the change by supporting the longstanding recommendation to vaccinate all babies against hepatitis B at birth, citing evidence that doing so has led to hep B infections plummeting in that time period.

The Allegheny County Health Department said in a Wednesday statement it was "deeply concerned" by the change.

"Our responsibility is to ensure that every newborn in Allegheny County receives the highest standard of protection," said ACHD Public Health Director Iulia Vann, in the statement. "The evidence is clear that the birth dose prevents infections that would otherwise lead to lifelong disease."

Hepatitis B is a virus that infects the liver and can lead to liver cirrhosis, liver failure and cancer. A vaccine to prevent the virus was approved by the Food and Drug Administration in 1981 and involved pooled blood from positive donors. That was discontinued in 1990, and a new vaccine that does not use blood products was released. You cannot get hep B from the vaccine.

Around 90% of babies infected with hep B at birth develop the virus, per the American Academy of Pediatrics, and 1 in 4 die from the disease.

Giving the vaccine at birth has reduced infections by 99% — 16,000 annual infections dropped to less than 20.

In its statement, ACIP said the birth-dose vaccination did not significantly contribute to the decline in cases and suggested it may be unnecessary. It recommended that mothers speak to their health care providers about weighing the risks and benefits of vaccination and that babies of mothers who are negative for hep B do not get the vaccine before two months of age.

During the ACIP meeting, Cynthia Nevison gave a presentation about the disease burden of hep B. Ms. Nevison is a climate researcher and does not have a medical degree nor experience in vaccines. Politico reported she had ties to groups that oppose vaccines.

Cody Meissner, former chief of the Division of Pediatric Infectious Diseases and former ACIP member, told the New York Times the meeting was "a terrible distortion of the facts."

Local physicians have maintained the previous recommendations that the benefits of vaccinating babies against hep B at birth outweighs the risks.

"UPMC experts continue to recommend Hepatitis B vaccination for newborns; it's safe and prevents deadly infection and is covered by insurance," said UPMC's chief medical officer, Donald Yealy, in a Wednesday email statement. "As always, UPMC strongly encourages patients to discuss medical decisions with their trusted health care provider."

Allegheny Health Network echoed those statements, saying the organization remains "firmly aligned" with the American Academy of Pediatrics and "strongly supports" universal hep B vaccination at birth, recognizing its "proven safety and effectiveness" at protecting newborns from preventable disease.

"With over 1 billion doses given to newborns across the country to date, the Hepatitis B vaccine has one of the most well-established safety records of any vaccine and is the best tool in pediatric medicine to protect babies from this chronic illness and possible liver cancer, according to clinical research," read the email statement. "In all cases, we continue to encourage caregivers to consult with their providers to make informed healthcare decisions about vaccinations for their children, and we value the shared clinical decision-making process between our pediatricians and families."

The Allegheny County Medical Society, established in the region in 1865, joined the local health department in its concern over the ACIP vote and said in an email that the decision will "worsen vaccine misunderstanding and further erode trust in public health."