Acting Health Commissioner Jeff Brown has signed an Executive Directive to protect the birth dose of the hepatitis B vaccine in New Jersey. This move follows discussions by the Advisory Committee on Immunization Practices (ACIP) at the Centers for Disease Control and Prevention (CDC), which recently debated changes to when infants should receive their first hepatitis B vaccine dose.
Governor Phil Murphy commented, “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. 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.”
Brown stated, “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. 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 keeps New Jersey’s recommendation that newborns receive their first hepatitis B shot within 24 hours after birth based on scientific guidance from organizations like the American Academy of Pediatrics (AAP) and consensus among regional public health groups. Healthcare providers are advised to use dosing schedules outlined by AAP.
Before routine infant vaccination began in 1991, thousands of children were infected each year—about half during childbirth and half through other exposures—highlighting why early vaccination is important. After implementation of universal birth dosing in the U.S., infant infections dropped by about 95%. The CDC estimates that more than 90,000 childhood deaths have been prevented since 1994 due to this vaccine.
Medical groups such as AAP, American Academy of Family Physicians, and American College of Obstetricians and Gynecologists have consistently recommended administering the first dose before hospital discharge.
At its recent meeting, ACIP voted for shared decision-making between parents and healthcare providers regarding timing or administration of hepatitis B vaccination for infants born to mothers who test negative for hepatitis B surface antigen. For those not receiving a birth dose immediately after delivery under these guidelines, ACIP suggests giving it no earlier than two months old but reaffirms immediate administration within 12 hours if there is a risk or unknown status.
The committee also approved aligning its Vaccines for Children program with these new recommendations and suggested antibody testing after an initial vaccine dose before additional doses are given; however, data supporting this practice is lacking according to state officials.
As yet, CDC has not formally adopted these recommendations.
Brown added: “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,” adding further that early vaccination protects against long-term complications.
Hepatitis B is a viral infection affecting the liver; acute cases can cause symptoms like fatigue or jaundice while chronic cases may lead silently toward cirrhosis or liver cancer over time. The virus spreads easily—even without symptoms—and can survive outside a body for up to one week; many people do not know they are infected.
Most commonly in infants, transmission occurs during childbirth via blood exposure; even minimal contact with infected blood can lead to lifelong infection. Babies exposed at birth face high risks: around 90% develop chronic infection compared with lower rates among older children or adults.
State law requires all hospitals in New Jersey both screen pregnant patients upon admission if their status is unknown or undocumented and encourage policies ensuring timely administration of appropriate immunoprophylaxis—including giving babies their first shot before leaving hospital care. More details are available at nj.gov/health/cd/topics/hepatitisb_perinatal.shtml.
Despite ongoing national policy debates about timing strategies for immunization across age groups:
– All infants should begin hepatitis B vaccinations at birth.
– Pregnant adults not yet vaccinated are encouraged to get protected.
– Unvaccinated individuals under age 60 remain eligible.
– Adults aged over 60 considered at increased risk may also seek protection if desired.
In addition, completion of this series remains required for entry into kindergarten/first grade in New Jersey schools.
To address barriers created by federal policies:
– On September 9th NJDOH authorized pharmacists statewide through executive order/standing order powers so anyone six months or older could access updated COVID-19 vaccines without prescription (for ages three-plus).
– On September 11th state insurance regulators urged continued coverage without cost-sharing.
NJDOH also worked with maternal-infant health agencies reminding families/providers about importance of COVID-19/hepatitis vaccinations during pregnancy.
A cross-agency Vaccine Workgroup was established late August involving multiple departments—including Human Services; Children & Families; Education; Banking & Insurance; Law & Public Safety’s Division Consumer Affairs; Treasury—to coordinate strategies minimizing interruptions in access/coverage across all recommended vaccines.
