The Advisory Committee on Immunization Practices (ACIP) began its December meeting this week with a closely watched review of several routine childhood vaccines, including renewed attention on the timing of the Hepatitis B vaccine for infants. The two-day meeting, held December 4–5 and streamed live by the Centers for Disease Control and Prevention, has drawn heightened public interest because of its potential to influence longstanding national immunization policy. The webcast remains available through the CDC at https://www.cdc.gov/acip/meetings/index.html.

According to ACIP’s published agenda, the committee is reviewing whether new evidence or clinical practice patterns should affect how the Hepatitis B vaccine is introduced in early life. The current recommendation, in place since 1991, advises that all newborns receive a dose of the vaccine within 24 hours of birth, followed by completion of the vaccine series during infancy. CDC research has shown that universal newborn vaccination significantly reduced early-life hepatitis B virus (HBV) infections over the past three decades, particularly in communities that previously experienced high rates of undiagnosed maternal HBV infection or limited access to consistent pediatric care. Public health groups describe the birth dose as a backstop for infants who may otherwise miss preventive care or whose parents may not know their HBV status.

So far, the committee’s discussions reflect tensions between risk-based and universal vaccination approaches. Media outlets covering the meeting have reported that some panelists raised questions about whether the birth dose should continue as a blanket recommendation for all infants, while others expressed concern that altering the policy could introduce gaps in protection. These reports emphasize that ACIP has not yet taken any final action. A spokesperson referenced in news coverage described the deliberations as ongoing, with additional analysis needed before any vote would occur. No official proposal has been released that would remove or replace the universal newborn recommendation, and no updated schedule has been approved by the CDC.

Several medical organizations submitted comments to ACIP ahead of the meeting, urging caution regarding any change to the infant HepB schedule. A letter from infectious disease experts, posted publicly by the Infectious Diseases Society of America, reiterated that hepatitis B remains a serious threat for infants exposed at birth or in the first months of life, noting that most chronic infections originate during early childhood. The authors warned that removing a universal birth dose could result in missed prevention opportunities, especially in hospital systems with uneven maternal screening rates. They cited CDC data showing that chronic HBV infection disproportionately affects Asian American, Pacific Islander, African immigrant, and other historically underserved communities. In these groups, gaps in screening and delayed vaccination can magnify lifelong risks of liver cancer and other HBV-related illnesses.

Equity considerations have also been a recurring theme in the broader public discussion surrounding ACIP’s review. Community health leaders point out that many families of color rely on the hospital birth setting as their most reliable point of access to preventive services. For parents working multiple jobs, lacking transportation, or living in areas without consistent pediatric care, delaying the first HepB dose until later well-child visits raises the possibility of missed protection. Advocates stress that universal vaccination at birth helps close these access gaps by ensuring that every newborn, regardless of insurance status, immigration background, or the ability to return for scheduled visits, begins life with critical preventive coverage.

ACIP’s December meeting comes during a period of sustained national attention on immunization policy. Vaccination rates declined during the COVID-19 pandemic, and many public health departments continue working to rebuild trust and reconnect families with routine care. For hepatitis B specifically, the CDC continues to encourage vaccination not only for infants, but for unvaccinated adults up to age 59 and older adults with risk factors. Expanding adult vaccination has also been identified as an important strategy to reduce HBV transmission in communities that face systemic barriers to healthcare access.

As of today, ACIP has not issued any new recommendations related to HepB vaccination, and the CDC has not updated the childhood immunization schedule. Any future action will require a formal vote, followed by review and approval from the CDC director before becoming national policy. Until then, the existing universal birth-dose recommendation remains in place.

Public health officials, clinicians, and community organizations serving diverse and underserved populations are expected to continue monitoring developments closely. Changes to early-life vaccination policy carry significant implications not only for individual families but for the broader effort to protect communities from vaccine-preventable diseases. As ACIP prepares its next steps, the outcome of this review will help shape how the nation approaches hepatitis B prevention at a time when health equity remains a central concern for many Americans.