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In a significant rift between clinical practitioners and federal advisors, a broad coalition of pediatricians, hospitals, and state health departments has announced they will reject the latest guidance from a Centers for Disease Control and Prevention (CDC) advisory panel. Instead, these medical professionals plan to uphold the long-standing standard of care: vaccinating all newborns against hepatitis B.
The conflict arises from a controversial vote last Friday by the Advisory Committee on Immunization Practices (ACIP). The panel moved to overturn a 34-year-old recommendation that advocated for universal hepatitis B vaccination at birth—a strategy credited with reducing infections in children by nearly 99%. The new guidance suggests limiting the birth dose only to infants born to mothers who test positive for the virus or whose status is unknown.
However, the medical community is pushing back, citing safety, history, and the overwhelming success of the current schedule.
Pediatricians Defy New CDC Panel Guidance
Hospitals and Health Alliances Draw a Line in the Sand
Leading medical institutions were quick to respond to the panel’s decision. Lurie Children’s Hospital of Chicago confirmed it would maintain its policy of administering the hepatitis B vaccine within 24 hours of delivery.
Dr. Larry K. Kociolek, a vice president and infectious disease expert at the hospital, emphasized that the current schedule isn’t arbitrary—it is built on decades of real-world success.
“The pediatric vaccine schedule currently adopted in the US is based on decades of research, extensive real-world experience, and vetting by well-trained and unbiased medical and public health experts,” Dr. Kociolek stated. He noted that the ACIP’s new recommendations were not driven by any new research suggesting the current vaccines are unsafe or ineffective. Consequently, major health alliances, including the West Coast Health Alliance and the Northeast Public Health Collaborative, have signaled they will continue to follow the American Academy of Pediatrics (AAP) guidelines rather than the new federal advice.
The Danger of a “High-Risk Only” Approach
The core of the medical community’s concern is the shift from “universal” coverage to “risk-based” coverage. Experts argue that relying on screening mothers to identify “high-risk” babies is a strategy that failed in the past.
Dr. Ravi Jhaveri, head of infectious diseases at Lurie Children’s Hospital, pointed out the flaw in the committee’s logic. “The new recommendation assumes that we can accurately predict who has infection and who will be exposed in the future; we cannot,” he explained.
Before the universal birth dose was introduced, approximately 30,000 children were infected annually. The stakes are incredibly high: about 90% of infants infected at birth develop chronic hepatitis B, and a significant quarter of those may eventually die from liver cancer or cirrhosis.
Pediatricians Defy New CDC Panel Guidance
Insurance Coverage and Legal Protections Remain Intact
One of the immediate fears for parents and providers was the financial and legal implication of ignoring CDC advisers. However, industry assurances have been swift.
Major insurers, including BlueCross BlueShield companies and members of AHIP (formerly America’s Health Insurance Plans), have confirmed they will continue to cover the birth dose of the hepatitis B vaccine. AHIP indicated that their members would cover all vaccines recommended as of September 1, ensuring no cost-sharing for families through late 2026.
Furthermore, legal experts are countering warnings from HHS Secretary Robert F. Kennedy Jr., who suggested doctors might face liability issues. Dorit Reiss, a law professor at UCSF, clarified that following the AAP vaccine schedule constitutes a recognized “standard of care,” which serves as a robust defense against malpractice claims.
Additionally, the hepatitis B vaccine remains under the National Vaccine Injury Compensation Program (VICP), providing a liability shield for providers and a recourse for families, regardless of the new advisory vote.
A Partnership Between Parents and Pediatricians
Ultimately, this divergence in policy places a premium on the doctor-patient relationship. Pediatricians are preparing to have more in-depth conversations with confused parents.
Dr. Lisa Costello of the AAP emphasized that parents “fiercely love their children” and want the best for them. The goal of pediatricians now is to cut through the noise and provide evidence-based reassurance.
Dr. Manisha Juthani, Commissioner of the Connecticut Department of Public Health, reiterated that informed consent remains the bedrock of medical practice. “No vaccine is put into a child without the consent of the parent,” she said, affirming that states will continue to encourage the birth dose as the safest path forward.
