24 Dec 2025 Hepatitis B Vaccination at Birth
The hepatitis B vaccine has saved millions of lives. Since its implementation in 1991, hepatitis B vaccination at birth has reduced pediatric hepatitis B infections by 99%.
When discussing hepatitis B vaccination with patients, especially the hepatitis B birth dose, frame the choice clearly: the hepatitis B vaccine has minimal risks and many benefits versus the lifelong risk of chronic liver disease and hepatocellular carcinoma.
The universal hepatitis B birth dose serves as a safety net, protecting all newborns, including those who may fall through the known gaps in prenatal screening, identification, and treatment.
Remember – hepatitis B is not only transmitted through sexual activity or injection drug use. Infants and children can acquire it from everyday contact with someone who is hepatitis B positive.
On December 5, 2025, the Advisory Committee on Immunization Practices (ACIP) voted to recommend shared decision making between healthcare clinicians and parents on the birth hepatitis B dose for infants born to hepatitis B negative parents.
The policy to administer hepatitis B vaccine and immunoglobulin (HBIG) to infants born to birthing parents with positive or unknown hepatitis B status has not changed.
Practice Implications
The hepatitis B first dose is still available for receipt after birth in the newborn nursery, even if the birthing parent is hepatitis B negative.
Parents can still choose to have their babies immunized with the standard 3-dose hepatitis B infant series.
Vaccines for Children (VFC) coverage: The hepatitis B birth dose is still available through the VFC program.
Next Steps
As always, immunization decisions should be made between clinicians and patients based on eligibility. Access should be ensured for the majority of parents who are choosing to protect their children through immunizations. Trusted clinicians like you can empower your patients with the information they need to make informed decisions.
Pediatricians and pediatric providers should review the newborn birth record and the Philadelphia Immunization Information System, PhilaVax, for hepatitis B vaccine administration to identify and vaccinate unvaccinated infants during clinic visits in the first month of life.
Birth hospitals and pediatric clinics should track hepatitis B birth dose refusals to assess the impact of recent messaging changes on parental immunization decisions. This guide can support you in building vaccine confidence with parents and documenting refusals.
For more information on hepatitis B disease and immunization, refer to this Philadelphia Department of Public Health alert.