A comprehensive review conducted by the Vaccine Integrity Project of the Center for Infectious Disease Research and Policy on the safety and efficacy of the birth dose of the hepatitis B vaccine found no benefit of delaying the first dose while showing significant reduction in infections for those vaccinated. The review, titled, “Hepatitis B Vaccination at Birth: Safety, Effectiveness, and Public Health Benefit,” pre-published online Feb. 5 (published in the May 2026 Pediatrics). The review supports previous studies examined by the Center for Disease Control’s Advisory Committee on Immunization Practices that showed that since initiation of the universal birth dose in 1991, and in conjunction with the full vaccine series, U.S. childhood hepatitis B infections have declined by 99%. The birth dose was implemented to close real-world gaps in prenatal screening and follow-up that left infants vulnerable to infection. In December 2025, Advisory Committee on Immunization Practices changed vaccine recommendations for infants born to women who test negative for hepatitis B infection in pregnancy, recommending “shared decision making,” whereby parents, in consultation with providers, consider “when or if” to vaccinate their child, and if not at birth, then at 2 months of age or later. Researchers, however, found no benefit of a delayed first dose for short- or long-term adverse events, vaccine efficacy, effectiveness, or long-term protection compared with vaccination at birth. The Advisory Committee on Immunization Practices also voted that post-vaccination antibody levels be considered to determine if infants should complete their hepatitis B vaccine series. Researchers found that completion of the full series confers optimal long-term immune protection and found no evidence that post-vaccination antibodies predict long-term immunity. Recent recommended changes to US vaccine policies were not supported by an analysis of the possible risks of delaying hepatitis B vaccination and decades of evidence that the hepatitis B birth dose has mitigated the spread of the virus nationwide.
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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.