Congress built the vaccine firewall. Now Congress must defend it.
Key takeaways
- On April 27, JAMA Pediatrics published two studies, neither of which was available to the advisory committee when it voted in December.
- The first modeled a single U.S. birth cohort, made up of 3.6 million infants.
- The other study asked what happens when the universal recommendation goes away.
Why this matters: political developments that affect policy direction and public trust.
Robert B. Shpiner, opinion contributor - 05/11/26 11:00 AM ET Comments: Link copied by Dr. Robert B. Shpiner, opinion contributor - 05/11/26 11:00 AM ET Comments: Link copied Getty Images At the end of 2025, the Advisory Committee on Immunization Practices walked back a cornerstone of American pediatric medicine: the universal hepatitis B birth-dose vaccine. The new recommendation calls for shared clinical decision-making for infants of hepatitis B-negative mothers, and no first dose earlier than 2 months of age.
The first numbers are now in. On April 27, JAMA Pediatrics published two studies, neither of which was available to the advisory committee when it voted in December. They used different teams and different methods, but they came to identical conclusions.
The first modeled a single U.S. birth cohort, made up of 3.6 million infants. Even under perfect adherence, a two-month delay of this vaccine projects 90 additional acute hepatitis B infections, 76 chronic infections, 29 hepatitis B-related deaths, and $16.4 million in lifetime healthcare costs from a single year s births. And these are best-case numbers. Adherence is never perfect, and the same delay reaches infants whose mothers hepatitis B status is unknown. Both gaps drive the toll up.