Last updated on December 11th, 2025 at 12:49 pm

With the CDC’s Advisory Committee on Immunization Practices (ACIP) poised to revise the schedule for the hepatitis B vaccine for infants and newborns, a new study provides overwhelming evidence that the potential changes will be risky.

Professor Dorit Rubinstein Reiss recently wrote about how the ACIP is supporting anti-vaccine views, which could put children and adults at risk from dangerous and deadly infectious diseases. This is part of HHS Secretary Robert F Kennedy Jr’s desire to disrupt and harm the US vaccine infrastructure.

It seems that RFK Jr’s anti-vaccine ACIP is focused on the hepatitis B vaccine. However, no science supports their claims about the hepatitis B vaccine, and, in fact, evidence-based medicine shows that removing the initial dose of the vaccine will put infants at risk for the disease.

Despite the efforts of RFK Jr and his anti-vaccine minions to obfuscate the facts about the hepatitis B vaccine and its value to saving the lives of infants, I will review this new report about the vaccine and help parents make the best decision to protect their children.

Hepatitis B and the vaccine

The hepatitis B virus (HBV) causes hepatitis B disease. I know that is an unusual way to describe it, but one needs to contract the virus to get the disease.

HBV is generally transmitted through blood and bodily fluids from an infected person. Hepatitis B is most commonly spread from mother to child at birth (perinatal transmission) or through horizontal transmission, especially from an infected child to an uninfected child during the first 5 years of life. The development of chronic infection is widespread in infants infected by their mothers or before the age of 5 years.

Hepatitis B is also spread by needlestick injury, tattooing, piercing, and exposure to infected blood and body fluids, such as saliva and menstrual, vaginal, and seminal fluids. Transmission of the virus may also occur through the sharing or reuse of contaminated needles and syringes or sharp objects, either in health care settings, in the community, or among persons who inject drugs. Sexual transmission is more prevalent in unvaccinated persons with multiple sexual partners.

The signs and symptoms of an acute infection with HBV are associated with general ill health, loss of appetite, nausea, vomiting, body aches, and mild fever – it can resemble a flu infection.

However, the infection then progresses to jaundice. The illness lasts for a few weeks (much longer than the typical course of a flu infection) – then, most individuals gradually improve. In some individuals, it may be asymptomatic; however, they can still pass the HBV to other people.

A few individuals may contract a more severe form of hepatitis B, which causes a form of liver disease called fulminant hepatic failure – these people may die as a result. 

The most important issue is that a chronic hepatitis B virus infection, whether it is asymptomatic or not, leads to chronic inflammation of the liver. This leads to cirrhosis over a period of several years. 

This type of infection increases the incidence of hepatocellular carcinoma. However, even in the absence of cirrhosis, the individual is still at risk of liver cancer.

Cancer arises from HBV as a result of several changes to liver cells (and, as we find out in the new research, many other cells) at the genetic level. Additionally, the damage caused by the virus leads to reactive oxygen species, which damage the DNA and will lead to the transformation of some healthy liver cells into cancer cells.

Hepatitis B may also be linked to other cancers, so preventing an HBV infection may provide benefits far beyond the liver.

The dangers of hepatitis B are clear. It is one of the most dangerous vaccine-preventable diseases.

The best way to prevent an HBV infection is with the hepatitis B vaccine, which can protect the individual for over 20 years, giving protection to the child as they enter adulthood. Then, adults can receive the vaccine again, especially if they have risk factors, like being a healthcare worker. 

Some treatments for HBV require taking daily medications for a year or more. And if that isn’t effective, second-line daily treatments, also requiring a year or more, may be employed. These are expensive drugs. 

Of course, since many individuals are asymptomatic, those individuals may not seek any treatment, which will lead to higher risks of many cancers. The adage, “a gram of prevention is worth a kilogram of cure” (or an “ounce of prevention is worth a pound of cure” for those barbarians who refuse to use the metric system), makes perfect sense – the HBV vaccine prevention is so much more valuable than the risk of the HBV infection.

Despite these facts, anti-vaccine activists, like RFK Jr, want to convince us that the vaccine is unnecessary. They claim that only sex addicts and drug abusers can contract the disease, although hepatitis B infections are frequent in those individuals; it’s ridiculous to believe that that’s the only way to contract the disease.

The hepatitis B virus can be transmitted through casual sex with a partner who may not know they have the disease. A cheating spouse (yes, I’m a cynic) could transmit the disease unknowingly to the mother. Healthcare workers who are exposed to blood may contract it. Several innocent modes of transmission of the virus do not include chronic sex or drug use. 

The anti-vaxxers have labeled the HBV vaccine as an “STD vaccine,” but that’s just a strawman argument, without any basis in scientific fact. As Vincent Iannelli, MD, wrote in his Vaxopedia blog:

Of the 40,000 newly infected people with hepatitis B each year, there are thought to be up to 950 infants who develop chronic hepatitis B from an untreated perinatal hepatitis B virus exposure. Even if it is more rare than that, skipping or delaying the birth dose of hepatitis B vaccine is an unnecessary risk.

And it is absurd to think that all of those 950 infants are born to drug-abusing, promiscuous mothers. As we mentioned above, many HBV infections are asymptomatic, which can still be passed on to the newborn. But more than that, the baby can be exposed to the virus at any time for the next 20 years, but they’re protected from the dangerous disease.

Of course, this all makes sense to me.

Hepatitis B vaccine and health of infants study

In a comprehensive review of hepatitis B vaccination, published on 2 December 2025, from the Vaccine Integrity Project from the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, ten researchers reviewed over 400 studies and reports over a four-decade span that had studied the vaccine’s safety and effectiveness.

Here are the key findings:

• Found no evidence that delaying the birth dose provides any safety or efficacy benefits.
• No short- or long-term safety differences exist between a birth dose and a delayed dose.
• No benefits in vaccine efficacy, immune protection, or durability were linked to a delay of the first dose.
• Delaying hepatitis B vaccination would reduce protection, particularly for infants affected by gaps in maternal testing and follow-up care.

The data seems clear enough, so the authors concluded:

The reduction of HBV infection among infants and children in the United States over the past 40 years resulted from a series of evidence-based recommendations. Each sequential modification was based on the systematic review of vaccine safety, efficacy, and effectiveness; HBV incidence; gaps in coverage; and quality improvement programs. Improved coverage of infants at birth, in combination with completion of the full hepatitis B vaccine series, resulted in protection of children and was foundational for interrupting HBV transmission to the next generation and the reduction of hepatitis B-related infection, chronic liver disease, cancer, and death in the entire US population.

In this review, we evaluated vaccine safety and the potential individual and population-level benefits of delaying the first hepatitis B vaccination compared with vaccination at birth. The hepatitis vaccine has consistently been shown to be a safe vaccine, regardless of timing of vaccination. This analysis found no differences in short-term or long-term adverse events related to the birth dose compared with a delayed first dose. No benefits of vaccine efficacy, effectiveness, or long-term protection were identified in delaying the first dose compared with vaccination at birth.

We also evaluated the potential population-level risks of delaying the first dose among infants born to HBsAg-negative mothers compared with those vaccinated at birth. This review found no evidence of any health benefit with delaying the birth dose and identified only risks related to changing current US recommendations for universal hepatitis B vaccination for all medically stable newborns weighing 2,000 grams or more within the first 24 hours of birth.

Let me repeat what the study authors concluded. There was absolutely no advantage in hepatitis B vaccine effectiveness and long-term protection from delaying the first dose compared to birth vaccination. They recommend that the hepatitis B vaccine schedule not be changed, because there are no benefits and numerous risks to children from delaying the vaccine.

Summary

In case you need further convincing, since birth-dose hepatitis B vaccination was adopted in 1991, infant HBV infections have been nearly eliminated — US pediatric HBV infections have declined by over 95%. A CDC study (before they went to the dark side of vaccine research) of infants born since 1994 estimated that the birth-dose strategy has prevented more than 6 million HBV infections and nearly 1 million hospitalizations for hepatitis B-related disease.

Thus, the current hepatitis B vaccine schedule prevents hepatitis B virus infections, prevents hospitalizations, and prevents cancer. The evidence is overwhelming — the hepatitis B vaccine for newborn infants is incredibly safe and overwhelmingly effective in preventing HBV infections.

I doubt that the current ACIP cares about evidence, and that’s sad. Their political agenda is more important than saving the lives of American children. And that disgusts me.

Citations

• Abers MS, Ulrich AK, Walensky RP. Universal Hepatitis B Vaccination at Birth-Risks of Revising the Recommendation. JAMA. 2025 Dec 3. doi: 10.1001/jama.2025.24996. Epub ahead of print. PMID: 41335428.
• Schillie S, Vellozzi C, Reingold A, Harris A, Haber P, Ward JW, Nelson NP. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2018 Jan 12;67(1):1-31. doi: 10.15585/mmwr.rr6701a1. PMID: 29939980; PMCID: PMC5837403.

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