In December 2025, the Centers for Disease Control and Prevention (CDC) adopted new guidance that supports individual-based decision-making for hepatitis B vaccination for infants born to women who test negative for the hepatitis B virus. This guidance, adopted following recommendations from the CDC’s Advisory Committee on Immunization Practices (ACIP), means that parents and clinicians may discuss vaccine benefits, infection risks, and timing together when deciding whether to administer the hepatitis B vaccine at birth or later in infancy. If the birth dose is deferred, the initial dose is now suggested to be administered no earlier than two months of age. CDC guidance continues to recommend that infants born to mothers who test positive for hepatitis B or whose status is unknown receive the birth-dose hepatitis B vaccine and hepatitis B immune globulin (HBIG) within12 hours of birth. The child and adolescent immunization schedule and related clinical guidance will be updated to reflect this recommendation. The decision to adopt individual-based decision-making reflects ACIP’s review of available evidence on prenatal screening reliability, the current low incidence of perinatal hepatitis B transmission in the United States, and the importance of maintaining protections where risk is highest while allowing flexibility for lower-risk situations.

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