Overview
At its December 2025 meeting, the Centers for Disease Control and Prevent (CDC) Advisory Committee on Immunization Practices (ACIP) voted to recommend individual-based decision-making for infants born to mothers who test negative for hepatitis B. The CDC adopted this recommendation on December 16, 2025. This means:
- Parents and clinicians may decide together whether to administer the hepatitis B vaccine at birth or begin the series later in infancy.
- If the birth dose is deferred, it is suggested that the series should begin no earlier than 2 months of age.
- Infants born to mothers who test positive for hepatitis B or whose status is unknown should continue to receive the hepatitis B vaccine within 12 hours of birth.
Why the Hepatitis B Immunization Recommendation Changed
This change to the child immunization recommendation for hepatitis B reflects the conclusions of ACIP, which determined:
- High reliability of prenatal hepatitis B screening, which identifies nearly all hepatitis B infections during pregnancy.
- Very low incidence of perinatal hepatitis B transmission in the U.S. due to existing prevention systems.
- Families and providers should be afforded flexibility when maternal hepatitis B status is confirmed negative.
- The need to maintain protections where risk is highest while allowing individual-based decision-making, including for timing, in low-risk infants.
What Expecting Parents Should Know
- Pregnant women should get tested for the hepatitis B virus. This test is covered across all insurance programs.
- Infants born to hepatitis B-positive or unknown-status mothers should receive hepatitis B vaccine and Hepatitis B Immune Globulin (HBIG) shortly after birth.
- For infants whose mothers test negative, parents and providers now have flexibility to determine if and when to begin the hepatitis B vaccine series.
- The hepatitis B vaccine remains a safe, effective tool for preventing serious liver disease in infants at risk.
- Individual-based decision-making — referred to as shared clinical decision-making on the CDC immunization schedule — means parents and health care providers weigh vaccine benefits, vaccine risks and infection risks together, then decide when or if a child should begin the hepatitis B vaccine series.
- Risk factors for hepatitis B include a household member with the virus or frequent contact with people from areas where hepatitis B is common.
Next Steps
CDC will:
- Update CDC.gov, including the child and adolescent immunization schedule webpages, to reflect shared clinical decision-making for infants born to women who test negative for hepatitis B.
- Develop materials to support clinicians in discussing vaccination timing with families.
- Continue to update the surveillance data for hepatitis B trends and vaccination coverage.
Secondary ACIP Recommendation
- ACIP also voted to recommend clinicians and parents consider serology (antibody level) testing when evaluating the need for subsequent hepatitis B doses in children.
- The agency will continue reviewing evidence related to ACIP’s serology-testing recommendation.