Key Points

Question  What is the impact of delaying vaccination against hepatitis B virus (HBV) among US infants? [JAMA - Pediatrics]

Authors: Eric W. Hall, PhD, MPH¹; Prabhu Gounder, MD, MPH²; Heather Bradley, PhD³ 

Findings  In this economic evaluation including 3.6 million infants, delaying administration of the first hepatitis B vaccine dose from birth to age 2 months for a single annual US birth cohort among infants whose birthing parents test negative for HBV could result in additional preventable HBV infections among children by age 18 years, including hepatocellular carcinoma cases, HBV-related deaths, and millions of dollars in excess lifetime health care costs.  

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Meaning  Study results quantify the importance of administering the first hepatitis B vaccine dose at birth for preventing childhood HBV transmission.

Importance  Universal administration of hepatitis B (HepB) vaccine at birth is a cornerstone for hepatitis B virus (HBV) elimination efforts in the US. In 2025, the Advisory Committee on Immunization Practices (ACIP) recommended delaying HepB vaccine initiation among infants born to birth parents who tested negative for hepatitis B surface antigen (HBsAg).

Objective  To evaluate the health and economic impact of delaying HepB vaccination among US infants.

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