The Colorado Department of Public Health and Environment (CDPHE) has announced that it will continue to recommend universal hepatitis B vaccination for all newborns in the state. This position follows a recent vote by the Advisory Committee on Immunization Practices (ACIP), which shifted its guidance from a routine recommendation for all newborns to a model where parents and doctors make the decision together, known as shared clinical decision-making. The change at the federal level does not alter Colorado’s existing requirements for hepatitis B vaccination for child care attendance.
State health officials stress that scientific evidence continues to support early hepatitis B vaccination as an effective measure to prevent lifelong infection, reduce liver cancer rates, and save lives. The vaccine, recognized as the world’s first cancer-preventing vaccine, has been studied extensively over more than three decades.
Since 1991, when national guidelines first recommended universal birth dose vaccination against hepatitis B, pediatric infections have dropped by 99% in the United States. In Colorado specifically, only 23 cases of perinatal hepatitis B were reported between 2001 and 2015; there have been 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.”
Health experts caution that discontinuing or reducing birth-dose coverage could risk reversing these gains. Nearly 29% of live births in Colorado occur without early prenatal care; many pregnant individuals may not be screened for hepatitis B before delivery. For those infants, receiving the vaccine at birth is often their only immediate protection.
“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.”
Although ACIP’s updated guidance allows families more flexibility through shared clinical decision-making—and maintains coverage through most insurance plans as well as programs like Vaccines for Children—CDPHE is implementing several measures to ensure clarity and access:
– Emergency rulemaking: CDPHE will propose emergency rulemaking with the Colorado Board of Health to reference the 2025 American Academy of Pediatrics immunization schedule within state regulations.
– Insurance coordination: The department is working with relevant agencies to ensure ongoing coverage across private insurance plans and public programs such as Medicaid.
– Education: New educational materials will be distributed to hospital-based providers and prenatal healthcare professionals regarding best practices in discussing vaccination decisions with families.
– Outreach: Efforts are underway to engage birthing hospitals and centers statewide about any challenges they face offering timely vaccinations.
For further information about preventing hepatitis B infection or infant immunization recommendations in Colorado, visit cdphe.colorado.gov.
