Colorado recommends continued universal hepatitis B vaccination for newborns

State affirms science-driven, decades-proven protection amid federal advisory changes

Denver (Dec. 5, 2025) — The Colorado Department of Public Health and Environment is recommending that health care providers continue offering the hepatitis B vaccine to all newborns at birth, reaffirming a practice backed by decades of scientific evidence, a strong safety record, and in line with recommendations from the World Health Organization (WHO), the American Academy of Pediatrics (AAP), the American Medical Association (AMA), and many others. This follows the Advisory Committee on Immunization Practices’ (ACIP) vote on Friday to change from a routine recommendation for all newborns to a decision that most parents and doctors make together, known as shared clinical decision-making. This recommendation does not change the existing hepatitis B vaccine requirements for child care attendance in Colorado per Board of Health rule 6 CCR 1009-2.

Colorado health officials continue to emphasize that the science supporting the hepatitis B birth dose remains clear: early vaccination prevents lifelong infection, reduces liver cancer, and saves lives. The hepatitis B vaccine is the world’s first cancer-preventing vaccine and has been extensively studied for more than 30 years. 

Since the universal hepatitis B birth dose was first recommended nationally in 1991, the U.S. has seen a 99% decline in pediatric hepatitis B infections. Colorado recorded only 23 cases of perinatal hepatitis B between 2001 and 2015, with no confirmed cases since 2016.

“Colorado has spent decades building an effective system of maternal screening and universal birth dose vaccination that has nearly eliminated infant hepatitis B infections in our state,” said Jill Hunsaker Ryan, executive director of CDPHE. “The evidence is strong, the science is clear, and the vaccine has an exceptional safety profile. We want providers and families to know that the hepatitis B birth dose remains safe, effective, and strongly recommended for all newborns.”

State experts caution that not having the recommended birth-dose could unintentionally reverse the progress we’ve seen, especially because nearly 29% of live births lack early prenatal care, meaning many pregnant individuals may not have been screened for hepatitis B. For their infants, the birth dose is often the only line of protection at the time of delivery.

“We support continued universal newborn vaccination with hepatitis B vaccine because the evidence base is strong and the risk of missing an infection at birth is real,” said Dr. Ned Calonge, Chief Medical Officer for CDPHE. “The hepatitis B vaccine has one of the best safety records of any childhood vaccine, and giving it at birth remains a critical tool to protect infants from preventable, lifelong disease.”

While ACIP’s new recommendation allows families to choose the birth dose of hepatitis B vaccine for their child through shared clinical decision-making and ensures continued coverage through most health plans and the federal Vaccines for Children (VFC) program, CDPHE is taking the following steps to provide clarity and maintain access for families and providers:

• Emergency rulemaking: CDPHE is proposing emergency rulemaking with the Colorado Board of Health to incorporate by reference the 2025 American Academy of Pediatrics (AAP) childhood and adolescent immunization schedule to ensure continued alignment between Colorado school vaccine requirements and the evidence-backed hepatitis B birth dose vaccine recommendation.
• Insurance coverage coordination: CDPHE is working with the Division of Insurance and the Department of Health Care Policy and Financing to ensure coverage continues across private insurance, Health First Colorado (Medicaid), and Child Health Plan Plus. Nothing has changed for state-regulated insurance plans.
• Education and awareness: CDPHE will develop and distribute educational materials for hospital-based providers and prenatal health care providers consistent with best practices for shared clinical decision making and resources for having conversations with patients and families about the continued importance of the hepatitis B birth dose.
• Hospital and birthing center outreach: CDPHE will perform outreach to birthing hospitals and birth centers across Colorado to identify and address any barriers experienced in offering the birth dose of hepatitis B vaccine to their patients. 

For more information about hepatitis B prevention and infant immunization recommendations, visit cdphe.colorado.gov.

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