Osterholm Update Special Episode: ACIP's Hepatitis B Vaccine Decisions
Dec 8, 2025
A recent decision by the ACIP to end universal hepatitis B birth dose recommendations raises alarms about public health. Dr. Osterholm expresses concerns over the implications for trust in federal vaccine guidance. He reviews the effectiveness of historical strategies against hepatitis B and highlights critical gaps in prenatal screening. Without new safety data, he predicts a rise in infant infections. The discussion also touches on the ideological motivations behind the decision, suggesting future threats to other vaccine recommendations.
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ACIP's Defining, Controversial Vote
- The ACIP voted to end the universal hepatitis B birth dose and limit it to infants of HBV-positive or unknown-status mothers.
- Michael Osterholm warns this reverses a long-standing public-health success and risks harm without new safety data.
Birth Is The Main Transmission Window
- Hepatitis B transmission to newborns mainly occurs during birth and was nearly eliminated by the universal birth dose plus HBIG for exposed infants.
- Osterholm emphasizes gaps in prenatal screening made universal vaccination the reliable safety net.
Screening Gaps Undermine Targeted Strategy
- Up to 18% of pregnant women are not tested for hepatitis B before delivery and many receive no follow-up.
- Osterholm argues the U.S. system has holes that universal birth dosing patched effectively.