ACIP delays vote on hepatitis B virus vaccine to December 5

The Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) met for the first of 2 meetings to discuss the hepatitis B virus vaccine dosing at birth.^1,2

According to the final agenda posted on December 4, the Committee was scheduled to vote on a pair of recommendation updates, though both were delayed until day 2 of the meeting, Friday, December 5. The push was the result of an initial motion to alter language for clarity and conciseness of the proposed votes. That motion was not seconded, though confusion about the language of the vote remained. As such, a separate motion was proposed to move the votes to Friday. This motion passed, so members could receive a copy of the proposed language and allow time for further language change consideration.

Initial votes

The following votes, published by the CDC, related to the hepatitis B virus vaccine were initially proposed, then delayed.³

VOTE 1

"ACIP recommends a birth dose of hepatitis B virus (HBV) vaccine and hepatitis B Immunoglobulin for infants born to women who test HBsAg-positive. ACIP recommends individual-based decision-making, in consultation with a health care provider, for parents deciding whether to give the HBV vaccine birth dose to infants born to women who are HBsAg-negative or whose HBsAg status is unknown. Parents should consult with health care providers and decide when or if their child will begin the HBV vaccine series. Parents and health care providers should consider vaccine benefits, vaccine risks, and infection risks. For those not receiving the HBV birth dose, it is suggested that the initial dose is administered no earlier than 2 months of age. Y/N"

VOTE 2

"When evaluating the need for subsequent HBV vaccine dose in children, parents should consult with health care providers to determine if a post-vaccination anti-HBs serology testing should be offered prior to subsequent HBV vaccine dose administration. Serology results should determine whether the established protective anti-HBs titer threshold of ≥10 mIU/mL has been achieved. The cost of this testing should be covered by insurance. Y/N"

The latest delay in voting on the proposed updated recommendations of the hepatitis B vaccine comes after votes were tabled during the Committee's September 2025 meeting, in which various votes on COVID-19 vaccination were discussed. Click here for a recap of the September 2025 meeting.⁴

"Rather than advance sound vaccine policy, this ACIP sowed doubt in the vaccines themselves. They spoke without evidence, and in most cases, they were just downright wrong," said José R. Romero, MD, FAAP, a member of the American Academy of Pediatrics' (AAP) Committee on Infecitous Diseases, in a media advisory briefing after the ACIP meeting.

"This is a significant departure from the historic role ACIP has played in shaping vaccine policy in the United States, when we could expect science to inform decisions, experts to debate evidence, and consensus to drive shared, clear recommendations."

History of the hepatitis B virus vaccine

The ACIP in 1991 recommended an at-birth dose of the vaccine,⁵ while current recommendations from the CDC, as of December 4, 2025, state the following individuals should receive the hepatitis B vaccine:⁶

• All infants.
• Unvaccinated children younger than 19 years of age.
• Adults 19–59 years.
• Adults 60 years and older with risk factors for hepatitis B.

The following groups may also receive HepB vaccination:

• Adults 60 years and older without known risk factors for hepatitis B.

AAP member Sean O'Leary, MD, also of the society's Council on School Health and someone who serves as chair of the Committee on Infectious Diseases, stated, "We are going to continue to recommend [hepatitis B virus vaccine] because it saves lives," according to an article from The Associated Press.⁵

The potential change of the vaccine schedule prompted the President of the AAP, Susan Kressly, MD, FAAP, to write a letter to the ACIP chair last week, stating in part that the vaccine has "one of the most well-established safety records of any vaccine," and adding that “Switching to a non-universal recommendation will result in many children contracting hepatitis B infection, with devastating results for their health,” she stated in the letter according to the AAP.⁷

What is next for ACIP?

According to the day 1 YouTube live stream of the ACIP meeting on December 4, the delayed votes on hepatitis B will be addressed on Friday morning, subject to further change, followed by the continuation of the planned agenda for day 2.²

According to the original agenda (subject to change), day 2 will consist of the welcome and roll call, a discussion of the childhood and adolescent immunization schedule—including the US-schedule comparison with other developed countries—the association between aluminum exposure from vaccines, and vaccines and aluminum adjuvants.¹

Continue to follow Contemporary Pediatrics for updates on the December meeting of the CDC's ACIP.

"Let me be very clear about this," Romero added. "Delaying the birth dose would leave newborns unprotected during a critical window in their lives. Children will die preventable deaths without timely access to the hepatitis B vaccine. The hepatitis B vaccine is one of the most important tools we have for protecting newborns in the first 24 hours of life."

References:

1. Meeting of the Advisory Committee on Immunization Practices (ACIP) agenda. CDC.gov. Published December 4, 2025. Accessed December 4, 2025. https://www.cdc.gov/acip/downloads/agendas/final-posted-2025-12-04-508.pdf
2. Advisory Committee on Immunization Practices (ACIP) - December 4, 2025 - Day 1 of 2. YouTube. Published December 4, 2025. Accessed December 4, 2025. https://www.youtube.com/live/LpthhPBFAgI
3. Next ACIP meeting: Anticipated votes. CDC.gov. Published December 3, 2025. Accessed December 4, 2025. https://www.cdc.gov/acip/meetings/upcoming.html
4. Fitch J. ACIP completes September meeting with votes on COVID-19 vaccines. Contemporary Pediatrics. Published September 19, 2025. Accessed December 4, 2025. https://www.contemporarypediatrics.com/view/acip-to-meet-for-mmrv-hep-b-covid-vaccine-proposed-recommendations
5. Stobbe M. What to know about the hepatitis B shot - and why Trump officials are targeting it. The Associated Press. Published December 3, 2025. Accessed December 4, 2025. https://apnews.com/article/hepatitis-b-vaccine-acip-a6032868d6025e2c527c574222fcabf3
6. Hepatitis B vaccine administration. CDC.gov. Published September 18, 2025. Accessed December 4, 2025. https://www.cdc.gov/hepatitis-b/hcp/vaccine-administration/index.html
7. Report: Hepatitis B vaccine safe, delaying would lead to increased infections. American Academy of Pediatrics. Published December 2, 2025. Accessed December 4, 2025. https://publications.aap.org/aapnews/news/33888