NJ Rejects CDC’s Latest Vaccine Recommendation

New Jersey is pushing back against new federal guidance adopted on Tuesday that allows parents to delay the Hepatitis B vaccine at birth.

The Centers for Disease Control and Prevention (CDC) adopted individual-based decision-making for hepatitis B immunization for parents deciding whether to give the hepatitis B vaccine, including the birth dose, to infants born to women who test negative for the virus.

Instead of at birth, the CDC is suggesting the initial dose be administered no earlier than two months of age.

Individual-based decision-making, referred to on the CDC immunization schedule as shared clinical decision-making, means that parents and health care providers should consider vaccine benefits, vaccine risks, and infection risks, and that parents consult with their health care provider and decide when or if their child will begin the hepatitis B vaccine series.

"This recommendation reflects [Prevention’s Advisory Committee on Immunization Practices] (ACIP)'s rigorous review of the available evidence," said Acting Director of the CDC and Deputy Secretary of Health and Human Services Jim O'Neill. "We are restoring the balance of informed consent to parents whose newborns face little risk of contracting hepatitis B."

Prior to the vote, Governor Phil Murphy said the updated recommendations by the ACIP "would weaken our ability to protect public health and stop the transmission of preventable disease. We know unequivocally that vaccines save lives."

The universal hepatitis B vaccine recommendation for all infants and young children was implemented in 1991.

Prior to that, around 18,000 children in the U.S. were infected each year before they reached the age of 10 years. Half of these infections were from mother to child during birth; the other half were from other exposures, according to the New Jersey Department of Health (NJDOH).

Murphy cited the statistics, adding that the vaccine "has proven to be one of the most effective childhood immunizations in preventing infections and deaths. In New Jersey, we are continuing to trust the science that has saved countless newborns from adverse health outcomes."

The NJDOH also previously issued an executive directive on Dec. 5 protecting the state’s requirement that all newborns receive a hepatitis B vaccine birth dose within 24 hours of delivery.

"New Jersey continues to recommend hepatitis B vaccination for all newborns within 24 hours of birth. For over 30 years, this approach has nearly eliminated hepatitis B in American children, preventing a disease that can cause lifelong liver damage, cirrhosis, and cancer," said Acting Health Commissioner Brown. "Through this Executive Directive, I reaffirm our commitment to protecting children and families in New Jersey with science-backed health guidance. We will continue to follow evidence-based recommendations that have kept our communities safe for decades."

In New Jersey, the hepatitis B vaccination series is required for school entry into kindergarten/first grade.

The NJDOH noted that these recommendations align with the American Academy of Pediatrics’ Recommended Child and Adolescent Immunization Schedule and reflect a previously released scientific consensus statement from the Northeast Public Health Collaborative.

"The hepatitis B vaccine has been safely given to millions of newborns, and delaying it unnecessarily puts children at risk from an entirely preventable disease," added Acting Commissioner Jeff Brown. “Vaccines remain our most effective defense against preventable illnesses. Early vaccination protects children from decades of health complications and gives families peace of mind."

Some local pediatric groups also shared social media posts about the Hepatitis B vaccine and its benefits, aligning with the state.

“At [Somerset Pediatric Group], we remain committed to practicing evidence-based medicine and following the trusted immunization guidelines set by the American Academy of Pediatrics. Our vaccine schedule has not changed and continues to reflect the best science available to protect your child’s health,” according to Somerset Pediatric Group.

Hepatitis B By the Numbers

• In 2024, there were 130 cases of acute hepatitis B and 1,846 newly identified cases of chronic hepatitis B reported in New Jersey. In the US, in 2023, there were 2,214 new cases of acute hepatitis B reported, with 17,650 cases of newly reported chronic hepatitis B.
• Worldwide, about 260 million people live with chronic hepatitis B, which means about 1 of every 32 people are living with a chronic hepatitis infection. In 2022, 1.2 million people died from hepatitis B worldwide. About 2,000 deaths from hepatitis B occur each year in the US.
• More than one billion doses of the hepatitis B vaccine have been given worldwide since its introduction in 1986.
• More than 8 of 10 infants born throughout the world receive three doses of hepatitis B vaccine. Numerous studies looking at the vaccine’s safety have been conducted by the World Health Organization, the CDC, and many medical societies, and have found no evidence that hepatitis B vaccine causes sudden infant deaths, autism, multiple sclerosis, or other neurological disorders.