State Supports Universal Hepatitis B Vaccine Birth Dose

December 11, 2025

On December 5, the Advisory Committee on Immunization Practices (ACIP) voted to eliminate the universal hepatitis B vaccine recommendation for infants.  

Because the new recommendation is not based on scientific evidence, the Minnesota Department of Health (MDH) is endorsing the evidence-based guidance of the American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) that supports the administration of a birth dose of hepatitis B vaccine for all infants.  

AAP’s and AAFP’s recommendations are noted on AAFP: Immunization Schedules and AAP: Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger (PDF). 

The new ACIP recommendation states that for babies born to mothers who test negative for hepatitis B (HBsAg-negative) during pregnancy, the decision to vaccinate against hepatitis B, including the birth dose, should be based on individual-based decision making (i.e. shared clinical decision making or SCDM). If this recommendation is approved by the Centers for Disease Control and Prevention (CDC) director, it will be added to the CDC’s immunization schedule. 

There is no change in the recommended hepatitis B vaccine schedule for babies born to mothers who test positive for hepatitis B (HBsAg-positive) or when maternal hepatitis B status is unknown. 

MDH does not expect access to the hepatitis B birth dose to be impacted by this change. ACIP changed its recommendation to shared clinical decision making, which will preserve access for hepatitis B vaccination for all children through the Vaccines for Children (VFC) program. 

Parents may have questions about the hepatitis B vaccine. It is important to be prepared to respond to these questions and talk with families about how the neonatal period is a vulnerable time for exposure to the disease and children exposed to hepatitis B early in life are much more likely to develop chronic liver disease. 

Here are some resources from trusted organizations that can help you have these conversations: 

• AAP: Childhood Guide HepB Family (PDF) 

• AAP: Childhood Guide HepB Clinician (PDF) 

• HealthyChildren.org: Understanding the Benefits of Vaccines: Common Questions 

• Vaccine Education Center at Children's Hospital of Philadelphia: Hepatitis B: What You Should Know Q&A (PDF) 

• Children's Hospital of Philadelphia: Hepatitis B: The Disease & Vaccines 

If you or your patients have questions, contact the MnVFC program at health.mnvfc@state.mn.us or the clinical team at health.vaccinesme@state.mn.us.