Targeted Hepatitis B Birth Vaccination May Increase Neonatal Infections

Chronic hepatitis B virus infection remains a significant global health challenge, contributing to a substantial portion of the nearly 10 million annual cancer deaths worldwide, particularly through the development of hepatocellular carcinoma [1, 2]. Vertical transmission from mother to child is a primary driver of the chronic disease burden, as infants infected at birth face a high risk of becoming lifelong carriers [3, 4]. Clinical evidence has long established that the administration of the hepatitis B vaccine and immunoglobulin to newborns is highly effective at preventing neonatal infection [5, 6]. While universal birth-dose vaccination has served as a safety net for infants of unscreened or falsely negative mothers, recent policy shifts have moved toward targeted strategies based on maternal surface antigen status. A new study now evaluates the potential clinical consequences of this transition in the United States, raising critical questions about whether removing the universal mandate might inadvertently increase neonatal infections in everyday practice.