Experts Urge Continued Universal Hepatitis B Vaccination
The Gastroenterological Society of Australia (GESA) joins leading international liver and infectious diseases organisations in expressing deep concern about the recent decision of the United States Advisory Committee on Immunization Practices (ACIP) to withdraw its longstanding recommendation for universal newborn hepatitis B vaccination.
Hepatitis B is a major global cause of cirrhosis, liver failure and hepatocellular carcinoma, and remains one of the most common causes of liver cancer in Australia. Universal birth-dose vaccination is a cornerstone of prevention: it is safe, effective, and supported by decades of evidence showing dramatic reductions in chronic hepatitis B and corresponding declines in liver cancer. Abandoning this public health practice — one that has protected newborns for more than 30 years — risks reversing hard-won progress and creating dangerous ambiguity for parents, health professionals, and communities.
International liver societies including the AASLD, ACG, AGA, ASGE, IDSA, NASPGHAN and the Hepatitis B Foundation have sounded the alarm, noting that universal birth-dose vaccination has prevented an estimated 95% of perinatal infections and over 90,000 deaths in the United States, and that reliance on maternal screening alone is insufficient.
The birth dose is essential: around 90% of exposed infants develop lifelong chronic infection, and the birth dose has a critical role to prevent an incurable chronic infection. Universal vaccination closes critical gaps arising from missed screening, documentation errors, out-of-hospital births, and variable access to postnatal care. We are against a shift toward an “individualised” opt-in model because of the risks that gaps will emerge, exposing children to risk.
GESA strongly reaffirms Australia’s long-standing commitment to universal hepatitis B birth-dose vaccination under the National Immunisation Program. This cost-effective, safe intervention prevents lifelong infection, organ failure and liver cancer, and protects infants from both mother to child and other later transmission throughout childhood and beyond. Safety surveillance across billions of doses confirms that hepatitis B vaccines are among the safest childhood vaccines ever developed, with serious adverse events extraordinarily rare.
We urge health authorities globally, including the CDC, to reconsider any move that weakens universal newborn protection. For parents and families, the message is clear: timely hepatitis B vaccination within the first 24 hours of life, followed by completion of the vaccine series, remains one of the most powerful lifelong protections we can offer every child. GESA encourages all parents to continue to follow evidence-based guidance and ensure their newborns receive the birth dose that safeguards both individual and community health.