Universal Hep B Vax at Birth: A Policy In Search Of Evidence

This debate exposes everything wrong with modern public health and it's terrifying

Defending weak science is accelerating the collapse of trust in public health - but today something historic is happening in American medicine.

Something that has the potential to change this.

And most people have no idea.

Right now, as you're reading this, a committee of experts is meeting to decide whether every newborn baby in America should get a hepatitis B vaccine within hours of birth.

A practice that has been happening for over 20 years. Without question. Without debate.

Until now.

The timing of this discussion couldn't be more important.

Vaccine uptake is declining across America. Trust in public health agencies has cratered.

The emergency powers wielded during COVID revealed how quickly "follow the science" can become "don't question the science"- almost entirely replacing transparency and rigorous debate with institutional defensiveness and coercion.

Today's meeting is a chance to start rebuilding that trust by acknowledging when policies don't match the evidence.

Here's why you should care

This review isn't about being "anti-vaccine"

It's about whether public health recommendations give you and your doctor honest information about medical decisions.

It's about whether public health agencies demanding "one size fits all" medicine makes sense when we're talking about the risks to your kids. It's about creating a system where patients can trust their doctors and health agency data enough to listen to their suggestions.

The way this debate plays out will affect every medical recommendation you get for the rest of your life.

When your doctor prescribes antibiotics for sepsis or recommends emergency surgery for appendicitis, those interventions have clear, immediate benefit that outweighs substantial risks. The evidence is overwhelming, the timeline is urgent, and delay means death or disability.

But does hepatitis B vaccination on day 1 of life carry the same strength of evidence?

For most newborns? Of course not.

But public health recommendations treat these situations as if they are the same.

It's far from true.

Public Health has lost the ability to distinguish between medical interventions that are truly necessary and those that are simply convenient or politically expedient policy choices.

And that loss of perspective is exactly why patients are refusing actual life saving testing or treatments recommended by their doctors because they inherently know that the risk to benefit ratio is not the same for every medical concern and suspect that they aren’t being told the truth.

When people know they are being lied to, everything gets thrown out.

Let me explain.

The basics everyone needs to understand

Hepatitis B spreads through blood contact, unprotected sex and sharing needles.

Newborns don't have sex. They don't inject drugs. They don't get tattoos.

So the only plausible way a baby can get hepatitis B is from an infected mom during birth.

Pregnant women are tested for hepatitis B.

If mom tests positive, baby absolutely needs the vaccine (+ additional treatments).

No one's arguing about that.

What if mom wasn't screened? Or she didn’t have access to prenatal care? Give the vaccine.

No one's arguing about that either.

The controversy prompting the recent fear mongering about potential ‘changes to the vaccine schedule’ is about your baby and mine. The ones born to mothers in stable relationships who already tested negative during their pregnancy.

Those babies? Public health guidelines say they all need it too as a matter of life and death. Just as much as the at risk babies above.

If you refuse, you're told your baby will die (seriously) or you’re referred to ‘social services’

No risk/benefit discussion.

Just give it to them. Shame or threaten the parents if you have to.

Every baby must get a shot. Every single one.

I asked a simple question on X

"Why should we recommend vaccinating the millions of babies born to Hep B negative moms who literally can't catch the disease because they are not exposed?"

The responses I received were... enlightening.

"Well, what if the husband is having anal sex with an IV drug user and contracts hepatitis B in later stages of mom's pregnancy?"

"What if the baby gets exposed through diaper changing stations at the hospital? You know the virus can live on surfaces for up to 7 days. What if the baby has a hangnail?"

Literally they used the hangnail example.

These aren't random internet trolls.These are actual arguments used by public health 'experts'

Think about that for a second. It's nonsensical.

The CDC says needle stick transmission from a confirmed Hep B + patient to an unvaccinated person has a maximum of 30% chance of transmission.

I know this because it’s exactly what I tell my patients who show up at the ER and have had direct, invasive, blood-to-blood contact with someone who 100% has the disease.

So if direct blood to blood is <= 30%, then diaper changing station with hangnails?

Come on.

In fact, there is actually ZERO data on risk of transmission from visually undetectable 7-day-old blood to a newborn's boo boo, as they have their diaper changed on a hospital changing pad or a Koala Care changing station in the mall. (trust me, I looked and I did find this interesting study in my search if you’re curious…)

If we're going to make medical decisions based on impossible-to-quantify fairy tales, we should at least to be honest about our logic.

Let’s consider why recommendations might be the way they are (other than corruption or money which are of course, always possibilities)

Why the recommendations exist (and it's not what you think)

There are really only a few plausible explanations for universal newborn hepatitis B vaccination that I could find:

Explanation 1: Future protection

"We're protecting against exposures that might happen when they're older. Better to vaccinate in infancy when the immune system responds well."

This sounds reasonable until you look at the data.

• At least 2% of children never develop immunity

• Studies show 50-76% of children lose detectable antibodies by adolescence. (evidence here, here, here, here, here)

So by the time these children might engage in high-risk behaviors- sharing needles, unprotected sex- many are no longer protected.

Explanation 2: Administrative convenience

New information is now being reported that an ACIP member who voted for universal newborn vaccination in 1991 has admitted what really happened.

The claim is that the committee couldn't figure out how to vaccinate the people who actually needed it: communities of people engaging in anal sex with numerous partners, IV drug users, inner-city youth.

So they decided to vaccinate all babies while they had a "captive audience" in hospitals.

Basically the source said, it's easier to give millions of shots to newborns than to design targeted programs.

Agencies also frequently claim (in the context of covid/flu recommendations, as recently as 2025)

• "It's just simpler to have one recommendation for everyone"

• "It reduces confusion"

Which sounds a lot like public health agencies basically admitting the policy exists because thinking is hard.

And if you believe the common sense assumption that if given to enough humans absolutely any drug will harm or kill a certain (hopefully very small) percentage of recipients, then the logic becomes:

“some number of babies who had nothing to benefit from the intervention, are subjected to it anyway and hurt or killed because thinking is hard”

Rather than allow doctors to do the work of individualized risk assessment for their patients, the system defaults to demanding every single baby be treated as “at risk” regardless of actual risk.

And it works.

When it’s officially ‘recommended’ for every newborn regardless of their level of risk/benefit ratio, doctors not ‘following the science’ are at risk. And so are parents - even though they are the ones following the actual science.

The ‘recommendation’ becomes coercive.

Explanation 3: The liability protection racket

Here's the part most people don't understand: vaccines enjoy legal immunity that other drugs don't have.

The National Childhood Vaccine Injury Compensation Act provides blanket liability protection for vaccines on the childhood schedule.

Drug companies literally cannot be sued for vaccine injuries if the vaccine is "recommended" for children.

So let’s compare that to another blood-borne disease: HIV

HIV prophylaxis doesn't have legal liability protection. (Neither do other drugs)

Is that why HIV prophylaxis isn't being pushed to prevent the mythical ‘hangnail’ related transmission I was informed of last night?

Legal liability changes the risk-benefit calculation completely- not just for patients, but also for pharmaceutical companies.

For HIV drugs: Company pays for injuries, faces lawsuits, has massive financial incentive to limit use to people who actually need it.

For hepatitis B vaccine: Company doesn't pay for injuries, faces zero liability if ‘recommended,’ has massive financial incentive to lobby to get in on the childhood schedule regardless of medical necessity.

So when there's literally no downside for the manufacturer, suddenly the "maybe your husband is having anal sex with an IV drug user" argument becomes a compelling business strategy.

The risk-benefit math is inherently different for vaccines because they have legal protection other drugs don't have.

Public health should just be honest.

Just say you can't figure out how to get the vaccinate people that are actually at risk if you let them out of the hospital without getting that initial dose

(although that immediately begs the question of what’s the point since it’s a 3-4 dose series, but I digress… ).

Admit that a percentage of babies will be hurt by this. (As is true for literally any pharmaceutical intervention)

And that, you think it’s the right thing to do anyway - at least from a public health perspective.

But that’s not what happens.

The comparison that breaks the argument

Back to HIV.

HIV passes from mom to baby. HIV prevention works. HIV kills you without treatment.

So if the "husbands cheat" argument justifies vaccinating every newborn in the US for Hep B, why don't we also give HIV prophylaxis to every newborn?

Sure it’s probably dangerous, but also HIV kills more often than Hep B.

Well…

We just don’t do it, because that would be insane.

We screen pregnant women and only treat the ones who need it. We target the moms and babies at actual risk.

We assess the risk/benefit and choose rationally.

Why does that logic not apply to hepatitis B? I don’t know.

But it doesn't.

Number needed to treat: how many babies have to get the shot to prevent one illness?

Less than 1% of American moms have hepatitis B.

Most cases are identified by routine screening.

Using the CDC's own transmission risk estimates, you need to vaccinate almost 1 million newborns to prevent one case of mother-to-child transmission.

And since not every one of those acute infections leads to chronic hepatitis B with serious complications, the number needed to vaccinate to achieve the goal of preventing chronic infection is actually greater.

If there were no risks, that might just be okay.

But what do we know about complications?

And the 'adverse events'?

Vaccines are known to permanently alter immune function - in fact that’s why we give them.

And there is growing concern that in doing so. they may also be causing unwanted changes.

Things like autoimmune conditions that take months or years to develop.

Here's what we know about hepatitis B vaccine and autoimmunity:

• A 2005 study found 60% of recipients developed immune reactivity against myelin (the protective sheath around nerves).

• Multiple studies documented increased rates of multiple sclerosis, particularly in young adults.

• A 2004 English study found MS patients were three times more likely to have received hepatitis B vaccine within three years of symptom onset.

These aren't conspiracy theories. These are published medical studies.

Are they adequate to prove causation? No.

There continues to be "more research needed."

Which begs another question: why is no one conducting well-designed, well-powered studies?

I suspect because there is no need to.

Universal vaccination is already recommended and completely free from liability, so what incentive is there to fund millions of dollars of research and disturb what’s already serving the industry?

But when parents ask about these risks, they get told the vaccine is "safe and effective." Or they are threatened with a ‘visit from social services.’

Ask me how I know.

That's not informed consent.

Where the vaccine actually works

Here's the thing: the hepatitis B vaccine demonstrates clear benefit in appropriate populations.

Healthcare workers: Annual infections dropped from 10,000 in 1982 to 304 in 2004 after workplace vaccination programs.

High-risk sexual practices : Clinical trials showed infection rates dropping from 25% to 3% in vaccinated groups.

Injection drug users: Systematic reviews show meaningful reductions in acute hepatitis B cases.

The vaccine works when given to people who are actually be exposed to the disease. Offer it to them.

Please.

The trust crisis we can't ignore

We can't keep shutting down legitimate questions about concerning health trends.

Childhood rates of autism, ADHD, allergies, and autoimmune conditions have increased dramatically over recent decades.

Is there rock-solid evidence that vaccines specifically cause these problems? No.

But there's also no rock-solid evidence that they don't.

The contradiction in messaging is clear to any critical thinker: You simply can't credibly claim "we don't know what's causing X, but we know with 100% certainty it's not Y"

It’s nonsensical.

‘Y’ is often replaced with, “the increase from a handful of vaccines to the 70 or 80 recommended for most children in 2025”

When parents see their children's health deteriorating, ask reasonable questions and are met with gaslighting and told their concerns are "conspiracy theories" they lose trust.

The CDCs own policies have created more ‘never-vaxxers’ than any misinformation campaign ever could.

The health equity problem nobody talks about

Poor vaccine recommendations don't hurt everyone equally. They disproportionately harm working-class families.

And no one screeching about "what's going to be covered" ever says that part out-loud.

Way 1: The compliant get hurt

Families who still trust all public health recommendations (like hep b at day 1 for low/zero risk newborns) are more likely to be harmed by receiving interventions with a terrible risk/benefit ratio for their child.

These working-class families don't have the time, resources, confidence or connections to question medical authority.

Meanwhile, more formally educated professionals- doctors, researchers, epidemiologists - increasingly opt out of questionable recommendations for their own families.

They know their kid isn't at risk of contracting a disease they aren't exposed to.

Those babies are safe because their parents know how to read studies, navigate the system, and make individualized risk assessments.

That leaves a large group of kids who are least likely to benefit from hepatitis B vaccination (low-risk infants in stable families) are most likely to get it and suffer potential injuries.

It’s horrific inequality disguised as inclusive public health policy.

Way 2: The suspicious refuse everything

Families who astutely recognize the corruption in our public health agencies, are increasingly declining all medical interventions.

Not just questionable recommendations, but literally everything.

The parent who has lost faith in the system doesn't just reasonably decline the hepatitis b vaccine for their newborn but they'll also decline the lumbar puncture that could identify an unrelated meningitis that proves deadly.

The family that lost trust over COVID vaccine mandates for 6 month olds, now refuses to bring their kid to the hospital for what turns out to be appendicitis.

These families bear the brunt of medicine's credibility crisis.

When public health officials defend indefensible policies, they don't just lose specific debates. They lose entire communities who stop trusting medical recommendations altogether.

The downstream effects are predictable and tragic.

People die from treatable conditions because they can no longer distinguish between interventions that make sense and those that don't.

Here's what's really at stake

Public health recommendations only work when people trust them.

That trust depends on honesty.

• When health officials make recommendations they can't justify with evidence,

• When they dismiss legitimate safety concerns,

• When they refuse to acknowledge that one size doesn't fit all,

They destroy the credibility they need to actually help people.

These downstream effects of broken trust will kill more people than honest discussions about vaccine risks ever could.

What informed consent actually means

Real informed consent means acknowledging that different people have different risks.

• A baby born to a hepatitis B positive mom? Clear benefit from the vaccine (and immunoglobulin) despite risks.

• A baby born to a hepatitis B negative mom in a monogamous relationship? Virtually zero benefit.

Our system pretends these scenarios are identical.

That’s not evidence-based medicine- it's bad science, ideology and religion.

Today changes everything

Right now, independent experts are reconsidering this policy for the first time in decades.

• They're free from pharmaceutical industry influence.

• They can look at the actual evidence without political pressure.

• They can model what honest, individualized medical recommendations look like.

The question is simple: Will they follow the science? Or will they keep defending one-size fits all medicine that can't be justified?

What rational policy could look like

Evidence-based medicine means using interventions where they work best.

Immediate changes: End universal newborn vaccination. Encourage vaccination when the risk/benefit calculation supports it. Maintain prenatal screening and targeted vaccination for high-risk mother-infant pairs. Focus resources on actual high-risk populations.

Evidence-based approach: Conduct well-powered, long-term safety studies with adequate control groups. Collect real data on adverse events. Study vaccine effectiveness in preventing chronic hepatitis B . Develop targeted outreach programs based on evidence instead of population-wide mandates.

The bigger picture

The hepatitis B debate isn't really about hepatitis B.

It's about whether we can have rational conversations about medical interventions.

It's about whether public health can acknowledge uncertainty and individual differences.

It's about rebuilding the trust that decades of dogmatic recommendations have destroyed.

When we treat every recommendation as equally sacred- from ICU protocols to population-wide prevention strategies—we invite skepticism of the entire enterprise.

The stakes couldn't be higher.

The trust we rebuild- or further destroy- with today's decision will affect public health for generations.

Medicine works best when doctors can be honest about risks and benefits.

When they can say "this makes sense for you" or "this doesn't."

When they can admit uncertainty instead of pretending every recommendation applies to everyone equally.

Today's ACIP meeting is a chance to get back to that kind of medicine.

Let's see if they take it.

[Watch the ACIP meeting live and see if evidence-based medicine makes a comeback]

Never medical advice.

Until next time,

Tiffany