NC pediatrician: What you need to know about hepatitis b vaccine changes and safety

The author is founder of Goldsboro Pediatrics, PA, and former president of the American Academy of Pediatrics and the NC Pediatric Society:

Recently, politicians at the federal level have decided to delay the birth dose of hepatitis b vaccine unless there is maternal hepatitis b blood test evidence that the baby needs the vaccine at birth. Physician groups including the American Academy of Pediatrics, the American Academy of Family Physicians, and the Infectious Diseases Society of America have agreed that this policy change is bad for children and that all children need to receive hepatitis b vaccine at birth if we are to prevent this uniformly fatal disease in at-risk children who might slip between the cracks under this new proposal.

North Carolina has one of the best childhood vaccine programs in the US because of a collaborative effort involving top-notch infectious diseases scientists and doctors in our medical schools, caring state government leaders and administrators, and practicing health professionals. This group made the decision to offer protection against hepatitis b infection to every baby born here in 1991, following expert recommendations.

This was the right decision then, and is the right decision now. It is painful to watch politicians destroy what has been a most effective immunization program that has saved thousands of children’s lives.

It is important to remember that hepatitis b is many times more contagious than HIV and that hepatitis b can be spread through casual contact with blood or body fluids in everyday environments like day care centers and schools. It is not just a sexually-transmitted disease. It is well-known that persons who become infected may not be diagnosable with blood testing for four weeks following exposure.

America in general, and North Carolina in particular, has a complicated and fractured health care system that can be difficult for parents and children to navigate. Not all pregnant women receive prenatal and post-partum care, and 14% of pregnant women here are never tested for hepatitis b. Not all parents bring their children to health care professionals for recommended preventive health services. Many families do not have health insurance that covers immunization costs.

However, the vast majority of our babies are born in a birthing hospital or clinic where caring health professionals try to provide the best evidence-based care for our newest North Carolinians. Cooperation involving federal and state government leaders, the health insurance industry, and birthing hospitals has removed financial barriers so that all babies can receive the birth dose of hepatitis b vaccine.

As the coalition of concerned leaders considered all these factors in 1991, the decision was made to offer hepatitis b vaccine to all babies born in our state, and to make sure all babies, whose parents consent, receive three doses of the vaccine by age six months. Such an approach has allowed us to significantly reduce the number of children who become infected with this incurable infection.

I have been giving recommended vaccines to children for over 50 years and have never seen a baby who experienced an adverse effect or injury from the hepatitis b vaccine.

I hope we can focus on what is best for our children and continue to offer the gift of hepatitis b vaccine to all babies born, as soon after birth as possible.

Christoph Diasio, MD, pediatrician and former President of the NC Pediatric Society, contributed to this op-ed.

This story was originally published January 12, 2026 at 5:00 AM.