TRENTON, N.J. — Acting Health Commissioner Jeff Brown on Friday signed an Executive Directive safeguarding New Jersey’s long-standing requirement that newborns receive the birth dose of the hepatitis B vaccine, reaffirming the state’s commitment to universal infant immunization amid shifting national recommendations.
The directive was issued as the Advisory Committee on Immunization Practices (ACIP), which advises the Centers for Disease Control and Prevention (CDC), met this week to discuss possible changes to when infants should receive their first dose.
“Updated recommendations from the Advisory Committee on Immunization Practices would weaken our ability to protect public health and stop the transmission of preventable disease. We know unequivocally that vaccines save lives,” said Governor Phil Murphy. “Since 1991, millions of newborns have received the birth dose of the hepatitis B vaccine, which has proven to be one of the most effective childhood immunizations in preventing infections and deaths. In New Jersey, we are continuing to trust the science that has saved countless newborns from adverse health outcomes.”
Under Brown’s directive, the New Jersey Department of Health will continue recommending that all newborns receive the hepatitis B vaccine within 24 hours of birth — a decades-old standard widely credited with nearly eliminating hepatitis B among U.S. children.
“New Jersey continues to recommend hepatitis B vaccination for all newborns within 24 hours of birth. For over 30 years, this approach has nearly eliminated hepatitis B in American children, preventing a disease that can cause lifelong liver damage, cirrhosis, and cancer,” Brown said. “Through this Executive Directive, I reaffirm our commitment to protecting children and families in New Jersey with science-backed health guidance. We will continue to follow evidence-based recommendations that have kept our communities safe for decades.”
The directive instructs health care providers to continue following dosing schedules recommended by the American Academy of Pediatrics (AAP) and endorsed by regional public health partners.
Background: concerns over ACIP’s vote
At its December meeting, ACIP voted to move the birth dose for certain infants under “shared clinical decision making,” meaning parents of babies born to hepatitis B-negative mothers could delay the vaccine until at least two months of age after consultation with their provider. ACIP reaffirmed that infants born to parents who are hepatitis B positive or whose status is unknown must continue to receive the vaccine within 12 hours of birth.
The committee also supported serology testing after the first vaccine dose — a measure some experts say lacks evidence for predicting infection prevention.
The CDC has not yet formally adopted these recommendations.
“The hepatitis B vaccine has been safely given to millions of newborns, and delaying it unnecessarily puts children at risk from an entirely preventable disease,” added Brown. “Vaccines remain our most effective defense against preventable illnesses. Early vaccination protects children from decades of health complications and gives families peace of mind.”
Hepatitis B: a highly infectious and often silent disease
Hepatitis B is a liver infection far more contagious than HIV and capable of surviving on surfaces for up to a week. Because symptoms often do not appear, many infected individuals — including infants and children — unknowingly transmit the virus.
An estimated 1,000 infants in the U.S. become infected each year, most commonly during birth. About 90% of exposed infants develop chronic hepatitis B, which can later lead to cirrhosis or liver cancer. One in four chronically infected children dies of the disease.
The universal birth dose has been credited with a 95% reduction in infant infections since the early 1990s and the prevention of more than 90,000 childhood deaths.
New Jersey maintains broad vaccination recommendations
Despite ACIP’s actions, New Jersey continues to recommend hepatitis B vaccination for:
- All infants, beginning with the birth dose
- All pregnant adults not yet vaccinated
- Anyone under 60 who has not completed the vaccine series
- Adults 60 and older at increased risk
The hepatitis B vaccine series is required for school entry in New Jersey.
State efforts to maintain broad vaccine access
The directive aligns with broader efforts by the Murphy administration to protect vaccine access, including recent actions to preserve coverage of updated COVID-19 vaccines and to streamline immunization availability through pharmacies and community partners.
More than one billion hepatitis B vaccine doses have been administered globally since 1986, and numerous studies have found no link between the vaccine and serious conditions such as autism or neurological disorders.
Additional information for prenatal providers and hospitals is available at nj.gov/health.
