Researchers Estimate Scaling Back Hepatitis B Vaccination Would Lead to More Infections

‘Our modeling shows how sensitive hepatitis B prevention is to changes in vaccination coverage at birth,’ one researcher said.

A nurse loads a syringe with a vaccine against hepatitis in Lynwood, Calif., on Aug. 27, 2013. Robyn Beck/AFP via Getty Images

Removing the universal hepatitis B vaccine dose for newborns would lead to more infections and deaths, according to two new studies released on April 27.

The Centers for Disease Control and Prevention in December 2025 said it was no longer recommending that infants born to women who tested negative for hepatitis B receive a dose shortly after birth, although the agency maintained the recommended dose for all other newborns. The update is on hold under a federal judge’s recent ruling.

Researchers at Boston University School of Public Health and other U.S. institutions modeled the impact of the updated recommendation and said it would likely result in fewer vaccinations among infants born to mothers who, despite being advised to test for hepatitis B, did not.

The model estimated that the former policy, which suggested that all newborns receive a hepatitis B vaccine dose within hours of birth, would result in a median of 1,292 hepatitis B infections and 1,162 chronic infections among 3.6 million infants.

The updated recommendation was primarily associated with an additional 69 or 628 infections and an additional 62 or 565 chronic infections, depending on the estimated percentage of mothers who still had their children vaccinated.

“Only when birth-dose vaccination coverage among unscreened infants met or exceeded 90% was the targeted recommendation associated with a comparable median number of infections,” the researchers said in the paper, which was published by JAMA Pediatrics, a journal run by the American Medical Association. The association, which accepts funding from vaccine manufacturers through its philanthropic arm, in 2025 voiced opposition to the CDC’s updated recommendation.

“Our modeling shows how sensitive hepatitis B prevention is to changes in vaccination coverage at birth,” Margaret Lind, an assistant professor of epidemiology at Boston University School of Public Health, and one of the researchers behind the paper, said in a statement. “Even under optimistic assumptions, lower coverage among higher-risk groups leads to increased infections, reinforcing the importance of maintaining high uptake to protect infants.”

Funding for the research came from the university and the National Institutes of Health. Several of the researchers reported receiving grants from pharmaceutical companies for work they noted was unrelated.

When the CDC updated its recommendation for hepatitis B vaccination, it also said that the first dose for children who did not receive a birth dose should be given at least two months after birth. The typical series has been one dose at birth, a second dose at one or two months of age, and a third dose from six months to 18 months of age.

In a separate study also published in JAMA Pediatrics, another group of researchers attempted to evaluate the impact of delaying administration of the first hepatitis B vaccine dose for some infants. The researchers said modeling indicated a delay would result in more infections and deaths related to hepatitis B, as well as millions of dollars in additional health care costs.

The authors did not list funding sources. They said they had no conflicts of interest.

The CDC’s update was based on advice from the Advisory Committee on Immunization Practices. A majority of members of the panel said that they were concerned about what they described as the lack of evidence supporting a birth dose for children born to women who tested negative for hepatitis B, as well as side effects from the vaccine.

Retsef Levi, a professor of operations management at the Massachusetts Institute of Technology, and one of the members who voted in favor of changing the recommendation, told The Epoch Times via email that both the papers “make arbitrary modeling assumptions, particularly regarding the risk that a baby born to a mother who tested negative for Hep B will become infected through horizontal transmission.” He also noted that neither considered vaccine side effects.

“Thus, not only that I do not find these two papers convincing, but I am concerned that they were written with a goal of obtaining a pre-defined answer,” he wrote. “These papers feel more like promotion of a policy to vaccinate all babies at birth, rather than an objective and data-driven analysis of benefits and risks.”

Dr. Kirk Milhoan, another committee member who favored changing the hepatitis B vaccine guidance, told The Epoch Times in an email that the models had inherent assumptions that demonstrated confirmation bias.

“I am comfortable with risk/benefit discussions in accordance with real world data and the medical ethics of informed consent,” he wrote.

The corresponding authors of the papers did not respond to requests for comment by the time of publication.