ACIP Votes on Hepatitis B Vaccine Recommendations

On December 5, 2025, the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) voted to recommend individual-based decision-making 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, ACIP suggested in its recommendation that the initial dose be administered no earlier than two months of age.

Individual-based decision-making, known on the CDC immunization schedules 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. ACIP said 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 relocated from areas where hepatitis B is common.

There was a second vote regarding the number of doses of hepatitis b vaccine an infant should receive. The current recommendations for the hepatitis b vaccine involves three doses - one given at birth, a second dose one to three months later and the third at six to fifteen months of age. ACIP voted to recommend evaluating the need for a subsequent hepatitis B vaccine dose, indicating parents should consult with health care providers to decide whether to test antibody levels to hepatitis surface antigen to evaluate adequacy of protection through serology results. This may mean that some infants get one or two doses of the hepatitis b vaccine instead of the standard three doses.

These recommendations on hepatitis B immunization maintain consistency of coverage for 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. ACIP on September 19, 2025, voted to recommend that all pregnant women be tested for the hepatitis B virus, a test that is covered across all insurance programs.

What Happens Next?

It’s important to note that ACIP’s role is advisory. Their recommendations are submitted to the CDC Director, who may accept them as-is, modify them, or reject them entirely. Until the CDC issues its final guidance, current vaccine schedules and funding mechanisms remain in place. PAMED will continue to monitor CDC actions and provide timely updates as decisions unfold.