This morning, after contentious discussion, the Advisory Committee on Immunization Practices (ACIP) voted 8-3 to drop the recommendation for a universal birth hepatitis B vaccine dose and 6-4 to suggest that parents use serologic testing—which detects antibodies in the blood—to determine whether more than one dose of the three-dose series are needed.

Under the first recommendation, only infants born to mothers who test positive for hepatitis B would receive a birth dose, while parents of other babies would be advised to postpone the first dose for at least two months.

ACIP makes vaccination recommendations to the Centers for Disease Control and Prevention (CDC), including those for different age-groups and disease risk status, as well as on US immunization schedules for children, adolescents, and adults. The CDC director has ultimate discretion whether to approve ACIP’s advice, and physicians can make their own decisions about whether to comply, but ACIP recommendations have historically affected insurance coverage of vaccines.