Study warns hepatitis B cases could soar if birth-dose vaccine guidance changes

A computer-based analysis published in the Annals of Internal Medicine examined how a single year’s worth of U.S. births would be affected by the CDC’s December 2025 recommendation to replace the universal hepatitis B birth dose with a shared decision-making approach for infants of hepatitis-negative mothers. The study, led by Harvard Medical School’s Amir Mohareb, found that if vaccination rates fall to roughly 26% when the first dose is given at two months, chronic hepatitis B infections could surge by 225% relative to current practice.

Even a modest 75% uptake at two months would still produce a 19% rise in chronic cases. The American Association of Pediatrics continues to advocate for birth-dose vaccination, and fifteen states have sued the Trump administration over the guideline shift. The authors note that repeated yearly effects could generate thousands of new lifelong infections, increasing cancer risk and health-care costs. Complementary modeling work highlights the need for expanded maternal screening and predicts additional billions in medical spending if the birth dose is delayed.