CHOP’s Guidance on Hepatitis B Vaccination for Newborns
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CHOP’s Guidance on Hepatitis B Vaccination for Newborns
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December 10, 2025

You may have heard news about changes to the recommendations for the hepatitis B vaccine for newborns. We know this can feel confusing or even worrying. At Children's Hospital of Philadelphia (CHOP), your baby’s safety is our top priority.

After reviewing the information carefully, CHOP is not changing our recommendation: We continue to strongly recommend the hepatitis B vaccine at birth because it has been proven safe and highly effective in protecting babies and children.  

This guide explains what changed, why CHOP’s guidance remains the same, and answers to questions parents often ask.

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Key takeaways

  • CHOP still recommends the hepatitis B vaccine at birth because it gives your baby strong protection right away.
  • The new national recommendation did not come from new scientific evidence.
  • Hepatitis B is a serious liver disease that can spread easily through tiny amounts of blood.
  • Many babies who get infected in their first year develop a lifelong infection.
  • The vaccine has been used safely for decades and is very effective. 

What changed in the national recommendation?

The national committee (ACIP) said that for babies whose mothers are hepatitis B negative, parents can now choose whether to give the birth dose or wait until 2 months of age. They did not change the recommendation for babies whose mothers are hepatitis B positive or whose status is unknown.

What is CHOP doing with this new information?

CHOP reviewed the update and the science behind it. Because there was no new evidence presented, CHOP is not changing our practice. We still recommend giving the hepatitis B vaccine within the first 24 hours of life.

Why does CHOP still recommend the birth dose?

We recommend the birth dose because it gives your baby protection right away, when they are most at risk. It has helped nearly eliminate hepatitis B infections in children.

  • Since the birth-dose program began, hepatitis B infections in children dropped 99%.
  • Babies can be exposed through small amounts of blood on shared items like toys or surfaces.
  • If a baby catches hepatitis B early in life, 90% develop a lifelong infection. 

Is the hepatitis B vaccine safe?

Yes. The hepatitis B vaccine has been used safely for more than 30 years. Serious reactions are extremely rare. 

What if we want time to think about it?

We understand this is a big decision. Our team is here to answer your questions and support you. We want you to feel comfortable and confident in whatever choice you make for your baby.

Frequently asked questions about hepatitis B and the vaccine

Why is hepatitis B dangerous? 

Hepatitis B can cause lifelong liver problems, including liver failure and cancer. Babies are especially vulnerable. 

How do babies get hepatitis B if the mother tests negative? 

Hepatitis B can spread through tiny amounts of blood that may be on shared items like toys, toothbrushes, or surfaces. The virus can live for up to a week.

Why does CHOP recommend the vaccine at birth instead of waiting? 

The first days of life are when babies are most at risk if exposed. The birth dose gives early, strong protection that has been proven to save lives.

Could the vaccine harm my baby?

The vaccine is very safe. Serious allergic reactions are extremely rare—about 1 in 1 million doses. 

What if we still choose to delay the vaccine? 

If you choose to delay, we will continue to support you. We will review the timing of the next doses and make sure your baby gets protected as soon as you’re ready.

Additional resources to help you make informed decisions

Hepatitis B: The Disease and Vaccines (from CHOP's Vaccine Education Center)

Watch: Why do Babies Need the Hepatitis B Vaccine?

Statements on vaccine access from public health officials in Pennsylvania (including the City of Philadelphia) and New Jersey

 

  • Why do newborns get the hepatitis B vaccine?

    Paul Offit, MD: Hi, my name's Paul Offit. I’m talking to you today from the Vaccine Education Center. What I thought we could talk about is, why is it that newborns get a hepatitis B virus vaccine? There are a number of reasons. First and probably most important, if a newborn catches hepatitis B virus, and typically catches it from passing through a birth canal, the mother’s birth canal that is contaminated with hepatitis B, they have a 90% chance of going on to develop cirrhosis, which is chronic liver disease, and liver cancer, which obviously is a fatal disease.

    The other thing I think most parents don’t realize is that before there was a routine recommendation for hepatitis B vaccine of newborns in 1991, every year about 18,000 children less than 10 years of age would get hepatitis B. Now about half of those children got it from their mothers as they passed through that birth canal that had hepatitis B virus in it. But the other half got it from relatively casual contact. Got it when uncle Bob came, who was a silent carrier of hepatitis B, but didn’t know it, and then kissed the child. Or got it from sharing toothbrushes with somebody who had hepatitis B at summer camp.

    So I think that it’s important to know that this is a virus that isn’t just transmitted by passing through an infected birth canal, or by sexual contact, or by tattoos, or by sharing intravenous needles. It also can be transmitted by routes that someone less than 10 can come in contact with.

    So, I think since we’ve have that recommendation in 1991, we essentially eliminated this disease in less than 19-year-olds. So I think it’s something to be proud of.

    Some parents could argue, “But wait a second, I had a hepatitis B virus test when I was pregnant and didn’t have it. So can’t I just wait to get the vaccine?” The problem with that is, I guess, twofold. One, no test is perfect, and secondly mom could inadvertently acquire hepatitis B after the test was preformed. So there’s no downside to getting the hepatitis B vaccine at birth. Also those who get it at birth, those studies have shown, are much more likely to complete that three-dose series.

    Thank you.
Transcript Transcript

Recommended reading
General Page

Hepatitis B: The Disease & Vaccines

All infants and young children are recommended to receive the hepatitis B vaccine to help prevent the severe liver disease that can develop if infected with hepatitis B virus.
Learn more
Condition

Hepatitis B

Hepatitis B is a virus that attacks the liver. It is a common infection worldwide, and affects about 1.25 million people in the United States. Hepatitis B can cause liver damage (cirrhosis) and liver cancer.
Learn more