A decades-old vaccination strategy that dramatically reduced childhood hepatitis B infections now faces a controversial rollback that could widen health disparities for Asian and African immigrant communities.
The CDC’s Advisory Committee on Immunization Practices issued revised guidelines in December recommending that only infants born to hepatitis B-positive mothers receive the vaccine at birth. Mothers who test negative can now opt out of newborn vaccination, a stark departure from the universal birth-dose policy that has been in place for years.
Dr. Samuel So, founder and executive director of the Asian Liver Center at Stanford University, warns the change is “short-sighted and not evidence-based.” He emphasizes that when newborns contract hepatitis B, between 50% to 90% develop chronic infections leading to liver cancer or cirrhosis, compared to just 5% of infected adults.
The stakes are particularly high for East Asian, South Asian, and African immigrant communities where chronic hepatitis B remains endemic. In the United States, Asians are nine times more likely to die from hepatitis B-related liver disease, while African Americans face two to three times higher mortality rates from complications.
So stresses that maternal testing alone is insufficient, noting that 15% of privately insured women aren’t tested during pregnancy. The virus is 50 to 100 times more infectious than HIV, and babies can be exposed through household contact or minor skin breaks.
Since universal vaccination began, chronic hepatitis B cases in children and adolescents have fallen by 99%.
See: “A Rollback at Birth: New Hepatitis B Guidance Could Deepen Health Disparities” (Jan 2, 2026)Â
