CDC Adopts Individual-Based Decision-Making for Hepatitis B Immunization for Infants Born to Women Who Test Negative for the Hepatitis B Virus

ATLANTA — December 16, 2025 — The Centers for Disease Control and Prevention (CDC) today adopted individual-based decision-making for hepatitis B immunization for parents deciding whether to give the hepatitis B vaccine, including the birth dose, to infants born to women who test negative for the virus. For those infants not receiving the birth dose, it is suggested that the initial dose be administered no earlier than two months of age.

Individual-based decision-making, referred to on the CDC immunization schedule as shared clinical decision-making, means that parents and health care providers should consider vaccine benefits, vaccine risks, and infection risks, and that parents consult with their health care provider and decide when or if their child will begin the hepatitis B vaccine series. Parents and health care providers should consider whether there are infection risks such as a household member who has hepatitis B or frequent contact with persons who have emigrated from areas where hepatitis B is common.

The child immunization schedule will be updated to reflect the recent recommendations by the CDC Advisory Committee on Immunization Practices, which were approved today by Acting Director of the CDC and Deputy Secretary of Health and Human Services Jim O’Neill. The CDC will also update applicable clinical guidance for hepatitis B vaccines to reflect and implement the new recommendation.

“This recommendation reflects ACIP’s rigorous review of the available evidence,” said Acting Director of the CDC and Deputy Secretary of Health and Human Services Jim O'Neill. “We are restoring the balance of informed consent to parents whose newborns face little risk of contracting hepatitis B.”

The CDC is reviewing ACIP’s secondary recommendation that parents should consult with a health care provider on serology testing to determine whether a subsequent hepatitis B vaccine dose is needed. For infants born to mothers who test positive for hepatitis B or whose status is unknown, the currently recommended birth dose of hepatitis B vaccine and immunoglobulin continues with no change.

The adoption of individual-based decision-making for hepatitis B immunization maintains consistency of coverage through all payment mechanisms, including entitlement programs such as the Vaccines for Children Program, Children’s Health Insurance Program, Medicaid, and Medicare, as well as insurance plans through the federal Health Insurance Marketplace.

Fact Sheet: Hepatitis B Immunization