Hepatitis B Vaccine Confusion Threatens Resurgence in Babies

Pediatrician warns that changes to vaccination recommendations could undo decades of progress against the liver disease.

Apr. 17, 2026 at 10:05pm

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A ghostly, translucent X-ray image revealing the internal structure of a newborn's liver, conceptually illustrating the health risks posed by the resurgence of hepatitis B due to falling vaccination rates.An X-ray view of a newborn's liver highlights the potential consequences of declining hepatitis B vaccination rates.San Diego Today

A recent study found that hepatitis B vaccination rates among newborns declined by more than 10% between 2023 and August 2025, raising concerns that the virus could make a comeback in the United States. The author, a pediatrician, argues that the changes to federal vaccine recommendations, which make the hepatitis B shot optional for babies born to mothers who test negative, could undermine the progress made in virtually eliminating the disease in children over the past decades.

Why it matters

Hepatitis B is a serious liver disease that can lead to chronic infection, cirrhosis, liver cancer, and liver failure. Before routine vaccination began in the 1990s, the virus infected roughly 18,000 children under 10 each year in the U.S., with about half of those cases passed from mother to child at birth. Universal newborn vaccination helped reduce infections to fewer than 20 per year, but the author warns that declining vaccination rates could undo that progress, just as measles has made a comeback due to falling vaccination levels.

The details

The author's recent study using national electronic health record data found that hepatitis B vaccination rates among newborns declined by more than 10% between 2023 and August 2025. While hepatitis B may seem like an unlikely threat to infants, the virus can spread through infected blood or bodily fluids, including from caregivers or family members. Before routine vaccination, about half of childhood hepatitis B infections were passed from mother to child during birth. The new federal recommendations make the hepatitis B vaccine optional for babies born to mothers who test negative, a change the author argues could undermine the progress made in virtually eliminating the disease in children.

  • In 1988, universal hepatitis B testing during pregnancy was recommended.
  • In 1991, universal newborn vaccination for hepatitis B was recommended.
  • In December 2025, the federal government's Advisory Committee on Immunization Practices revised its recommendation for newborn hepatitis B vaccination.
  • Earlier in 2026, the Centers for Disease Control and Prevention revised its childhood immunization schedule, moving several vaccines from being universally recommended to being suggested as topics of discussion for parents and providers.

The players

Joshua Rothman

A pediatrician at UC San Diego Health and a clinical assistant professor of pediatrics at the UC San Diego School of Medicine.

Advisory Committee on Immunization Practices

The federal government's advisory committee that revised the recommendation for newborn hepatitis B vaccination.

Centers for Disease Control and Prevention

The federal agency that revised the childhood immunization schedule, moving several vaccines from being universally recommended to being suggested as topics of discussion.

American Academy of Pediatrics

The organization that created its own immunization schedule that largely maintains the previous recommendations, in response to the CDC's changes.

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What they’re saying

“Vaccination decisions are influenced by science but also by trust and consistency. When parents receive mixed messages, some begin to question whether vaccines are necessary at all.”

— Joshua Rothman, Pediatrician

What’s next

A federal judge has temporarily blocked the changes to the federal vaccine recommendations and invalidated actions taken by the advisory committee. The outcome of this lawsuit could have significant implications for the future of childhood vaccination policies in the United States.

The takeaway

The decline in hepatitis B vaccination rates among newborns, coupled with changes to federal recommendations that make the vaccine optional, could undo decades of progress in virtually eliminating this serious liver disease in children. This serves as a warning that when we stop using vaccines that work, the diseases they prevent can come back, as seen with the resurgence of measles.