Secretary of Health and Human Services Robert F. Kennedy, Jr., speaks in the Oval Office of the White House in Washington, as President Donald Trump, left, and Mehmet Oz, Administrator for the Centers for Medicare & Medicaid Services, look on. [AP Photo\/Alex Brandon]<\/p>\n
In what public health experts are calling the most consequential attack on disease-prevention policy in modern US history, the Centers for Disease Control and Prevention (CDC), under the control of the Trump administration, has voted to delay the Hepatitis B vaccine for newborns.\u00a0<\/p>\n
The decision effectively dismantles the decades-long standard of administering the first dose within the first 24 hours of life, a cornerstone of the universal immunization strategy that has protected millions of infants from a lifelong, incurable viral infection. The \u201cbirth dose\u201d is needed because maternal infection is often asymptomatic, and screening fails to identify all infectious mothers. This critical vaccination has helped reduce pediatric Hepatitis B infections<\/a> by more than 95 percent since 1991.<\/p>\n This vote by the CDC\u2019s Advisory Committee on Immunization Practices (ACIP) is part of the Trump administration\u2019s campaign, led by Health and Human Services Secretary Robert F. Kennedy Jr., to dismantle public health in the United States. What is being implemented under the guise of \u201chealth freedom\u201d is, in fact, the demolition of the very institutions and structures that have protected millions from infectious disease.<\/p>\n The path to this outcome was paved through a calculated dismantling of the public health advisory structure, a central component of the Trump administration\u2019s broader war on science. Earlier this year, Kennedy took the unprecedented step of firing all 17 members of the existing ACIP panel\u2014historically composed of experts in vaccinology, infectious diseases, epidemiology and immunology\u2014and replacing them with anti-vaccination advocates.<\/p>\n The committee\u2019s decision to delay the birth dose runs counter to 40 years of safety and efficacy data. Anticipating the administration\u2019s intent to undermine the standard of care, the Vaccine Integrity Project at the University of Minnesota\u2019s Center for Infectious Disease Research and Policy (CIDRAP) undertook an independent review<\/a> of the evidence.<\/p>\n Led by Dr. Angela K. Ulrich and Dr. Michael T. Osterholm, the CIDRAP analyzed more than 400 studies spanning four decades. Their conclusion was unequivocal: \u201cThere is no new evidence to suggest that delaying the birth dose would be safer or more efficacious.\u201d The review reaffirmed that the birth dose reduces perinatal transmission by about 70 percent on its own\u2014and up to 97 percent when paired with hepatitis B immune globulin. It also found no causal links between the birth dose and serious adverse events, refuting the pseudoscience used to justify the delay.<\/p>\n These findings build upon a vast historical record. A 2024 CDC analysis<\/a> led by Dr. Fangjun Zhou, a health economist in the Immunization Services Division, estimated that routine immunizations administered to children born between 1994 and 2023 prevented an estimated 508 million illnesses and 1.1 million deaths, saving nearly $2.7 trillion in societal costs.<\/p>\n To justify the delay, the committee raised theoretical concerns about the \u201ccumulative effect\u201d of vaccines and specific ingredients such as aluminum adjuvants. Newly appointed ACIP members have been tasked with investigating questions such as whether \u201cthe two different aluminum adjuvants increase the risk of asthma.\u201d<\/p>\n But these concerns have already been tested. A landmark nationwide cohort study published in the Annals of Internal Medicine<\/a> in July 2025, led by Dr. Niklas Worm Andersson of the Statens Serum Institut in Denmark, examined 1.2 million children and found no association between aluminum-adsorbed vaccines and autoimmune, allergic or neurodevelopmental disorders\u2014including autism and asthma.<\/p>\n The consequences of this policy shift have already been modeled in detail, and the projections show a significant rise in preventable illness, cancer, death and long-term healthcare costs.<\/p>\n In a preprint study<\/a> titled \u201cEconomic Evaluation of Delaying the Infant Hepatitis B Vaccination Schedule,\u201d Eric W. Hall of Oregon Health & Science University assessed the lifetime clinical and economic impact of delaying the birth dose for the 2024 US birth cohort. The model incorporates the realities of the US healthcare system, including \u201cimperfect adherence\u201d\u2014the well-documented fact that when the birth dose is not administered in the hospital, the likelihood of completing the full vaccine series drops sharply.<\/p>\n According to Hall\u2019s modeling, even a brief delay of the first dose until two months of age for infants born to mothers not known to be infected would result in 1,437 additional preventable acute Hepatitis B infections in children, 304 additional cases of liver cancer, 482 additional HBV-related deaths, and $222 million in excess healthcare costs annually.<\/p>\n The alarm over the decision has been immediate across the medical and public health community. The American Academy of Pediatrics (AAP) called the delay \u201ca direct threat to infant safety,\u201d warning that it \u201ccontradicts every major body of scientific evidence accumulated over four decades.\u201d The Infectious Diseases Society of America (IDSA) condemned the vote as \u201can abandonment of the standards that protect children from preventable disease.\u201d The Association of Immunization Managers, representing state and territorial immunization programs, cautioned that the shift will \u201cundermine the integrity of vaccination schedules nationwide.\u201d<\/p>\n Members of the CDC Alumni Association described the vote as \u201ca grave departure from evidence-based practice\u201d and warned that abandoning the birth dose \u201cwill result in unnecessary and irreversible harm.\u201d Several former leaders of the Immunization Safety Office noted that the decision \u201cmakes no scientific sense and violates the precautionary principle that has guided immunization policy for decades.\u201d These warnings\u2014coming from the very people who built the nation\u2019s immunization infrastructure\u2014underscore the unprecedented nature of the collapse now unfolding.<\/p>\n