New U.S. hepatitis B vaccine policy targeting only at-risk newborns could raise infant infections and costs, studies warn

A new U.S. recommendation limits the birth‑dose hepatitis B vaccine to infants who are judged to be at risk of neonatal infection, rather than offering it universally to all newborns.

One study conducted by researchers at Boston University, the University of Florida and Johns Hopkins University warns that avoiding an increase in neonatal infections under the targeted approach would require screening levels for maternal hepatitis B that have never been achieved, as well as near‑perfect birth‑dose coverage for infants of unscreened mothers.

A second analysis from Oregon Health and Science University and partner institutions projects that delaying the first vaccine dose will lead to more chronic hepatitis B cases in children, which in turn will generate additional health‑care spending.

Both studies suggest that the policy could reverse progress made in reducing infant hepatitis B transmission and impose a financial burden on the health system, prompting calls for reconsideration of the targeted recommendation.