An advisory committee of the Centers for Disease Control and Prevention (CDC) has postponed a vote on a proposed change to the hepatitis B vaccination schedule for infants. The proposed change would have delayed the first dose from within 24 hours of birth to a later point in infancy or childhood, unless the mother is known to be infected.

Here’s what you need to know about the hepatitis B virus (HBV) and the vaccines.

### What Is Hepatitis B?

Hepatitis B virus (HBV) attacks the liver and is the leading cause of liver cancer worldwide. Many infected people do not have symptoms and are unaware they are infected.

In most adults who acquire the virus, the infection resolves on its own. However, HBV becomes chronic in more than 90% of infants and up to 50% of young children who become infected. Decades after infection, patients can develop liver failure and may require a liver transplant. Since there is no cure for HBV infections, patients often experience recurrent liver disease even after a transplant.

### How Common Are HBV Infections Today?

In the U.S., HBV infection rates have dropped nearly 90%, from about 9.6 per 100,000 before vaccines became widespread to approximately 1 per 100,000 in 2018.

Globally, the World Health Organization (WHO) estimates that 254 million people were living with chronic hepatitis B infection in 2022, with 1.2 million new infections each year.

### How Is the Virus Transmitted?

Hepatitis B is most commonly transmitted through contact with body fluids from an infected person.

### Why Is the Vaccine Given to Newborns?

Before the hepatitis B vaccine was widely available, transmission from mothers to babies during childbirth was the most common way infants became infected.

In the U.S., prior to vaccination, roughly 85% of newborns became infected if their mothers had active infections. Approximately 30% of babies born to mothers with previous, inactive infections also became infected.

Currently, only 0.7% to 1.1% of infants born to infected mothers develop infection after vaccination at birth, according to the CDC. Similar declines in infant HBV infections have been observed worldwide with widespread newborn vaccination.

As of 2020, 190 out of 194 WHO member countries had adopted hepatitis B vaccination for infants, according to a 2022 CDC report. More than half of these countries provide the vaccine to all newborns immediately after birth.

### What Is the Current Vaccine Recommendation in the U.S.?

Since October 2016, the CDC’s Advisory Committee on Immunization Practices (ACIP) recommends that all medically stable newborns receive the first dose of the HBV vaccine within 24 hours of birth, followed by additional doses at 1–2 months and 6–18 months of age.

This updated recommendation replaced the previous 2005 guideline which suggested the initial dose be given before newborns were discharged from the hospital.

If a mother is known to have an active HBV infection, the birth dose is given within 12 hours of birth, along with special antibodies to fight the virus.

Additionally, ACIP recommends three doses of the hepatitis B vaccine for unvaccinated children and adults under age 60, as well as for older adults with risk factors for hepatitis B or those who seek protection without risk factors.

The CDC affirms that “scientific evidence overwhelmingly supports the safety” of the six hepatitis B vaccines currently licensed for use in the United States.

### Why Treat All Babies, Not Just Those with Infected Mothers?

Universal birth dosing protects infants whose parents’ HBV status is unknown or who were not tested during prenatal care.

Maternal testing can also miss recent infections, so universal newborn vaccination is more reliable.

Furthermore, even when mothers are not infected, newborns can acquire HBV from close contact with other infected individuals.

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*Published on September 20, 2025.*
https://www.thehindubusinessline.com/news/science/hepatitis-b-vaccine-for-newborns-why-the-first-dose-within-24-hours-matters/article70071739.ece