Illinois should continue to recommend that nearly all newborns be vaccinated against hepatitis B, a state advisory committee decided Tuesday, in a move that could represent another break with federal vaccine guidance.

The Illinois Department of Public Health Immunization Advisory Committee voted unanimously Tuesday that Illinois “reaffirm and maintain” the recommendation that nearly all babies be given the vaccine within 24 hours of birth. The committee’s recommendations aren’t final, but will be considered by the director of the state health department, who can issue official guidelines for the state.

The committee’s vote Tuesday followed a decision by a federal vaccine advisory committee earlier this month to no longer recommend hepatitis B vaccines for all newborns. That federal committee voted 8-3 to recommend that it be left up to parents and doctors to decide whether to vaccinate newborns if the infants’ mothers test negative for hepatitis B. Infants of mothers who test positive for hepatitis B or who aren’t tested would continue to receive the vaccine shortly after birth.

The federal committee also voted to suggest that when a family decides not to vaccinate their newborn against hepatitis B, that the first dose of the vaccine be given at no earlier than 2 months old. The federal committee’s recommendations will become official once they’re approved by the director of the Centers for Disease Control and Prevention.

For years, the federal government had recommended all newborns receive the shot to prevent serious liver damage that can be caused by the infection. Most adults who contract hepatitis B make a full recovery, but newborns and babies infected with the virus during the first year of life have a 90% chance of developing chronic hepatitis B, and chronic hepatitis B can lead to liver damage, liver failure, liver cancer or death, according to the American Academy of Pediatrics.

Members of Illinois’ Immunization Advisory Committee said during their meeting Tuesday that they did not think changes were needed to previous federal hepatitis B vaccine recommendations for newborns.

“I have trouble seeing that this is a public health problem,” said committee chair Dr. Marielle Fricchione, of vaccinating newborns against hepatitis B. “To me, it looked like a successful public health policy and appropriate for our country and the health care system that we have.”

Though pregnant women are typically tested for hepatitis B as part of their prenatal care, doctors warn that the illness, which is typically spread through bodily fluids, can be spread by others as well. Dr. Brian Borah, with the Chicago Department of Public Health, also noted that there can be gaps when it comes to catching all cases of hepatitis B among pregnant women.

The Chicago Department of Public Health identified 808 infants who were exposed to the illness from 2015 to 2024, Borah said. Over that time, the number of babies identified as exposed each year decreased significantly, dropping from 114 in 2015 to 40 in 2024. Only one newborn in Chicago during that time was identified as actually having caught the illness from their mother. When babies are exposed to the illness at birth they’re typically given antibodies as well as the vaccine.

“There are people who may become infected and will not trigger a positive test because of the timing of when the tests were done,” said committee member Dr. Edward Linn. “We’ve seen a diminishing number of cases, but it’s a devastating disease and leads to very significant long-term problems and risks for those individuals that slip through.”

Illinois is not the only state to part ways with the federal government when it comes to vaccine recommendations after Robert F. Kennedy, Jr. – head of the U.S. Department of Health and Human Services and a longtime vaccine skeptic – fired and replaced all the members of the federal vaccine advisory committee earlier this year.

Illinois also previously broke with the federal committee’s recommendations for COVID-19 vaccines, after that committee voted to no longer recommend the shots and instead leave it up to individuals whether to get them.

Earlier this month, Gov. JB Pritzker signed a bill into law formally establishing the process for the state to issue its own vaccine guidelines.

Dr. Sameer Vohra, director of the state health department, also reaffirmed at the vaccine advisory committee’s meeting Tuesday that, for other routine vaccinations, Illinois will continue to recommend CDC immunization schedules for children and adults issued as of Aug. 7, 2025, before the federal vaccine advisory committee began making controversial changes.

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