On December 5, 2025, the Center for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) voted to overturn guidelines for universal hepatitis B virus (HBV) vaccinations at birth despite decades of evidence-based recommendations. Hepatitis B vaccinations are highly successful at reducing the incidence of acute hepatitis B infection by 99% in the United States and preventing progression to chronic HBV infection. 

Current guidelines recommend that all infants receive a series of 3 doses of the HBV vaccine, starting immediately after birth and followed by two additional shots at 1 to 2 months and 6 months of age. The newly voted rules will only recommend HBV vaccinations at birth for infants born to mothers with positive or unknown hepatitis B status. Infants born to mothers with negative hepatitis B status will no longer receive a HBV dose at birth. Instead, mothers will need to discuss with their physicians to decide to vaccinate at birth or delay until at least 2 months old. By delaying vaccination by 2 months, this policy creates a window of infection that puts undue risk upon infants of mothers with negative hepatitis B status.

What is Hep B? 

Hepatitis B virus is a bloodborne pathogen that can be passed down from mother to child. Acute infection can manifest as jaundice and nonspecific symptoms like fever, fatigue, nausea, and vomiting an average of 90 days after exposure. Infected children and adults can also be completely asymptomatic. Two in three individuals living with hepatitis B infection do not know they are infected.

Unvaccinated children can acquire the virus and develop chronic hepatitis B, which has no cure. Children are especially at risk to develop chronic hepatitis B infection:

• 90% of infants when infected at birth 
• 50% of children between age 1 to 5 

In the United States, Asian American, Native Hawaiian, and Pacific Islander (AANHPI) individuals represent half of all chronic hepatitis B infections in the United States despite making up 7.5% of the U.S. population. 

Why is this a concern?

HBV causes permanent damage to the liver over time, causing cirrhosis and liver cancer. In fact, chronic hepatitis B is responsible for more than half of all hepatocellular carcinomas in the world. The risk of developing hepatocellular carcinoma increases with every year of chronic HBV infection. 

Call to Action

National APAMSA strongly condemns the ACIP decision to roll back universal hepatitis B vaccination at birth. Institutionalized vaccine hesitancy is a disservice to our communities, especially to Asian American, Native Hawaiian and Pacific Islander communities who face a disproportionate burden of chronic hepatitis B infections. These rules will undoubtedly reverse the decades-long progress in reducing hepatitis B in the United States and hurt all communities that we, as future physicians, swear to serve. As mentioned in our policy compendium and Hepatitis Initiative, APAMSA is committed to advocating for universal hepatitis B vaccinations and increased funding and awareness for hepatitis screening. We urge that ACIP and policymakers reconsider their decision to pivot from evidence-based recommendations that can potentially harm the next generation of Americans. 

Our Current Work

1. National Hepatitis B Pledge:  Inspired by Stanford’s Asian Liver Center and San Francisco’s Hep B Free, we hope to encourage all medical students to develop habits of screening and advocacy for hepatitis that will follow them in their careers as physicians. 
2. 2025 Advocacy Day and Hepatitis, Equity, Advocacy, and Leadership (HEAL) Summit – APAMSA hosted the inaugural Advocacy Day on Capitol Hill and the HEAL Summit (formerly known as Hepatitis Conference) in Washington, D.C. During this two-day event, students sat down with Congressional members to advocate for increased awareness and funding for Hepatitis B and heard from the nation’s leading experts on hepatitis and advocacy. 
3. Grants for Hepatitis Screening: – Apply today to receive up to $1500 for hepatitis screening and education events – applications accepted on a rolling basis.
4. Curated list of resources for hepatitis education and screening tools