The Maryland Department of Health raised concerns Friday over a federal advisory panel’s vote to scale back recommendations for the hepatitis B vaccine in newborns, a move officials said could jeopardize infant health across the state.
The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, or ACIP, voted 8-3 during its December 4-5 meeting in Atlanta to limit the birth dose of the hepatitis B vaccine to infants born to mothers who test positive for the virus. For other newborns, whose mothers test negative or have unknown status, the panel recommended shared decision-making between parents and health care providers to weigh benefits, risks and infection chances before administering the shot. If the birth dose is deferred, ACIP suggested starting the series no earlier than two months of age.
Maryland Health Secretary Vidya Seshamani, who oversees public health initiatives for the state’s roughly 6 million residents, issued a statement decrying the change as a departure from evidence-based practices. “This week’s federal Advisory Committee on Immunization Practices’ (ACIP) discussion and vote to change the hepatitis B vaccine recommendations for infants is an alarm bell for all who hold rigorous, evidence-based science as their North Star,” she said.
Seshamani emphasized the vaccine’s proven track record, noting it has undergone extensive testing for safety and efficacy over decades. When given within 24 hours of birth, the shot prevents newborn infections effectively, she said. “Delaying the vaccine or not completing the full series has no known safety benefits for children. The ACIP’s action will lead to worse health outcomes for Maryland newborns.”
The full three-dose series—typically the birth dose, a second shot at one to two months and a third at six to 18 months—provides lifelong protection against hepatitis B, a liver-attacking virus that can lead to chronic infection, cirrhosis, liver failure and cancer. Infants who contract the virus face a 90 percent chance of chronic illness, compared with 5 percent in adults.
In Maryland, where about 72,000 babies are born annually, the universal birth dose has aligned with state efforts to curb hepatitis B transmission. The Maryland Department of Health mandates the vaccine for school entry in grades K through 12, alongside requirements for other immunizations. Prenatal screening for hepatitis B surface antigen, or HBsAg, is routine, with universal vaccination recommended regardless of results to catch gaps in testing—such as recent infections or household exposures missed during pregnancy.
State data show high compliance: Before the ACIP vote, more than 90 percent of eligible newborns in Maryland hospitals received the hepatitis B vaccine prior to discharge, exceeding national averages of about 70 percent within 24 hours. Southern Maryland counties—Calvert, Charles and St. Mary’s—mirror this trend, with birthing centers at facilities like MedStar St. Mary’s Hospital in Leonardtown reporting vaccination rates above 85 percent for the birth dose. Local health departments in these areas, serving populations with diverse risk profiles including rural communities and military families at Naval Air Station Patuxent River, promote the shot through free clinics and education programs.
The ACIP shift stems from a review initiated under U.S. Health and Human Services Secretary Robert F. Kennedy Jr., who has questioned aspects of childhood vaccine schedules. The panel, reshaped with new appointees in September 2025, debated the birth dose’s necessity for low-risk infants, citing theoretical safety concerns not supported by cumulative evidence. Presentations during the meeting included claims of potential links to autoimmune issues, though multiple studies affirm the vaccine’s safety profile, with no increased risk of infant death, fever, sepsis or multiple sclerosis.
Opposition came from medical groups like the American Academy of Pediatrics and the Pediatric Infectious Diseases Society, whose nonvoting liaisons protested the process as lacking rigorous scientific review. Dr. Grant Paulsen, representing the latter, questioned the push to alter a policy that has slashed U.S. childhood hepatitis B cases by 99 percent since 1991. That year, ACIP first recommended universal infant vaccination to address perinatal transmission, where up to 85 percent of exposed newborns became infected without intervention.
In Maryland, the change could complicate delivery room protocols at hospitals from Baltimore to Southern Maryland’s community centers. Nurses and pediatricians already counsel parents on the vaccine, often bundling it with vitamin K shots and newborn screenings. Shifting to case-by-case decisions might strain resources, especially in underserved areas like Charles County’s rural pockets, where access to follow-up pediatric visits at two months isn’t always immediate.
Seshamani’s statement underscored Maryland’s commitment to countering potential fallout. “Vaccines are one of the most powerful and effective tools to protect against severe illness and keep our communities healthy. The Maryland Department of Health will continue to take the necessary steps to ensure broad vaccine access in Maryland and protect our people.”
The department plans to maintain its protocols, urging providers to administer the birth dose universally and offering free vaccines through the state-supplied program for uninsured families. Education campaigns will ramp up, targeting Southern Maryland’s close-knit communities via partnerships with groups like the Southern Maryland Tri-County Health Council. These efforts build on historical successes: Pre-vaccine era data from the 1980s showed Maryland hepatitis B rates 10 times higher among children, with clusters in immigrant-heavy areas like Prince George’s County adjacent to Southern Maryland.
The ACIP vote requires CDC director approval before altering official guidelines, a step expected soon. If finalized, it won’t immediately affect insurance coverage—private plans, Medicaid and the Vaccines for Children program must cover recommended shots—but could influence provider practices and parental hesitancy. Nationally, hepatitis B persists as a threat, with 3,000 acute cases reported in 2024, mostly among unvaccinated adults; chronic carriers number 800,000 to 2.2 million.
Maryland’s stance reflects broader tensions in public health policy. Since the 1991 recommendation, global vaccination has prevented 370 million infections and 11 million deaths, per World Health Organization estimates. Locally, Southern Maryland providers report few refusals—under 5 percent in recent audits—but emphasize informed consent, explaining transmission risks beyond maternal status, such as through shared razors or minor household cuts.
