Delaying Infant Hepatitis B Vaccination Increases Infections and Costs

Hepatitis B virus remains a significant driver of global morbidity, contributing to a substantial portion of the nearly 600,000 annual deaths from liver cancer worldwide [1, 2]. While universal infant vaccination is a cornerstone of elimination efforts, mother-to-child transmission continues to pose a serious public health challenge, with transmission rates reaching as high as 31.3 percent in the absence of prophylaxis [3]. Current clinical guidelines emphasize the importance of triple panel testing (a screening process involving hepatitis B surface antigen, antibody to surface antigen, and total antibody to core antigen) during pregnancy to identify at-risk neonates and ensure timely immunoprophylaxis [2]. However, the implementation of birth-dose protocols varies globally, and the clinical impact of altering these schedules remains a subject of intense debate [4, 5]. Prompted by a 2025 Advisory Committee on Immunization Practices recommendation to delay vaccine initiation for certain infants, a new analysis evaluates the health and economic consequences of postponing this critical first dose in the United States.