RFK Jr. Reshapes Childhood Vaccines, Ends Hepatitis B Shot at Birth

What Happened

The CDC’s newly restructured vaccine advisory panel, now operating under the leadership of Health Secretary Robert F. Kennedy Jr., has voted to end the recommendation that every newborn in the United States receive a hepatitis B shot at birth. The vote was 8-3 to replace guidance that has been in place since 1991.

Under the new policy, only newborns whose mothers test positive for hepatitis B or whose maternal status is unknown will receive the birth dose. If a mother tests negative during pregnancy, the first shot may be delayed until two months of age or later. The familiar three-dose hepatitis B series will still exist, but its timing will now depend on the child’s circumstances and conversations between parents and physicians.

The panel described the decision as an effort to update guidance to reflect current infection patterns and screening practices. Nearly all pregnant women in the United States are tested for hepatitis B. The disease has become less common among young people. This is due to decades of vaccination, improved maternal screening, and better antiviral treatment for adults who carry the virus.

Federal officials noted that for babies born to infected mothers, the shot at birth remains essential. Without it, the risk of long-term infection is extremely high.

Why It Matters

Ending the blanket recommendation marks one of the most consequential changes to childhood vaccination guidance in more than three decades. The birth dose has long been viewed as a foundational part of the childhood schedule because hepatitis B can cause lifelong liver disease if contracted early in life. The recommendation was created at a time when maternal screening was inconsistent. The disease was far more widespread.

Today, most pediatric care begins with electronic records of prenatal tests. Hospitals can see immediately whether a mother carries the virus, and infants can be treated accordingly. The change ends a recommendation that public health officials credit with a steep decline in childhood hepatitis B cases since the early nineties. The birth dose created a safety net when maternal test results were missing or inaccurate.

Public health leaders who favored the old policy believe that the benefit of delivering the vaccine at birth was its consistency. Regardless of what information was missing, the infant received protection.

The new guidance places more decision-making in the hands of parents and primary care providers. This aligns with Kennedy’s stated emphasis on individualized medical decisions. It also stresses the importance of follow-up visits, record-keeping, and communication between obstetric and pediatric teams.

How It Affects Readers

For parents, the most immediate change is the timing of the first hepatitis B shot. Families will now discuss the schedule with their pediatrician rather than follow a nationwide rule that applied to everyone. If the mother tested positive or her status is not known at delivery, the child will still be vaccinated at birth. If the mother tests negative, the family can decide whether to delay the shot until the two-month checkup.

For hospitals, the change increases the importance of prenatal screening and accurate documentation. Clinics must verify maternal test results and confirm which infants qualify for a delayed schedule. This could reduce the number of shots given on the first day of life.

For public health agencies, the change will require monitoring. The hepatitis B birth dose created a uniform layer of protection and helped suppress infection rates. With the timing now flexible for many infants, officials will need to watch for any rise in missed doses or delayed protection in the first months of life.

Whether the change strengthens individualized care or complicates safeguards will become clearer as physicians, parents, and hospitals adjust to the new system. The decision is notable because it ends a nationwide practice that shaped childhood vaccination for a generation. It replaces it with one centered on targeted risk and clinical judgment.