CHIBE Scientific Director calls ACIP vote to end universal newborn Hepatitis B vaccination “deeply disappointing”

The Advisory Committee on Immunization Practices (ACIP) recently voted to end a decades-long recommendation that all newborns receive the hepatitis B vaccination. The CDC vaccine advisors recommended that the vaccine be given to infants born to women who test positive for the virus or whose status is unknown.

“The result, if approved by the CDC’s acting director, will be a rollback of a universal recommendation to start hepatitis B immunization at birth, a standard practice in the U.S. for more than 30 years that has been credited with dramatically lowering liver diseases caused by the virus,” NPR reported.

CHIBE Scientific Director Dr. Alison Buttenheim, a vaccine acceptance expert, offered her thoughts on the vote.

What’s your reaction to the news that the ACIP voted to end the recommendation that all newborns receive the hepatitis B vaccine?

It’s deeply disappointing to watch a policy that has quietly protected millions of babies get dismantled on the basis of selective data and a process that felt, frankly, engineered for a predetermined outcome.  

The universal birth dose was one of those rare, beautifully simple public-health policies that actually worked: it protected every baby, closed equity gaps, and didn’t depend on a parent remembering one more thing in the haze of early postpartum life.  

Recasting this as “provider discretion” creates the impression that the vaccine is optional because there’s something wrong with it—despite decades of evidence to the contrary. This is how you take a settled scientific success and turn it into a source of public doubt.

Now, the panel recommends that new parents who test negative for the virus should consult with their providers to decide when/if their child will be vaccinated against the virus at birth. What effect do you think this will have  — that the default would no longer be to recommend immunization for all babies?

Defaults matter, and ACIP just replaced a clear, protective default with a foggy “ask your provider” that parents will understandably interpret as a warning sign. The universal birth dose worked because it was simple and equitable; this new setup adds friction and invites doubt.

When a vaccine that’s been routine for decades is suddenly framed as optional, people assume there’s a reason to hesitate. And hesitation won’t fall evenly—families with fewer resources or less consistent access to care will be the ones who miss out. This changes a proven public-health safety net into a patchwork.

Could you talk about the role in trust with vaccines? Do you think there is more confusion now about who to turn to for the best information? Do you have any advice for people?

A decision made through a confusing process and wrapped in glossy “shared decision-making” language is bound to erode trust. Parents can feel when signals get muddy, and muddy signals create space for misinformation to rush in.

What makes this moment especially dispiriting is that the very institutions meant to offer clarity (HHS, CDC, ACIP, even VRBPAC) are now generating more confusion and friction instead. These should be deeply trusted public-health authorities, but decisions like this make it harder for the public to treat them that way.

The safest move is to anchor yourself to groups that consistently apply clear, evidence-based standards: the American Academy of Pediatrics, the Immunization Action Coalition, and your state or local health department.

And if you’re feeling uncertain, that’s not a personal shortcoming! The policy shift itself is creating the confusion. Good guidance should reduce cognitive load, not increase it.

Anything else you think is important to add?

The HepB birth dose has been one of public health’s quiet workhorses: an elegant, low-friction intervention that quietly protects every baby, every time. Dismantling it doesn’t add value; it just adds complexity, and complexity is the oldest, most reliable way to erode confidence in something that works.

This shift will fall hardest on families who already face the most barriers, because universal policies are what keep protection equitable. Good vaccine policy should make the right thing easy. This one makes it harder for no clear benefit.

Any further reading you’d recommend?

I highly recommend Angie Rasmussen’s substack post or Dorit Reiss’ STAT News OpEd. Both Dorit (from the law/policy angle) and Angie (from the infectious disease epi angle) have deep expertise and credibility in this space.