Jill Burcum: A newborn care delay that could be deadly

Against the advice of leading medical societies, federal health officials recently upended a key component of newborn care: the universal recommendation that all infants receive the hepatitis B vaccine within 24 hours of birth.

The move came in December under the dubious leadership of U.S. Health and Human Services (HHS) Secretary Robert F. Kennedy Jr., who has embraced vaccine conspiracy theories and wields sweeping influence over the nation's public health agencies.

His imprint was obvious on the CDC's Advisory Committee on Immunization Practices vote late last year to end that 34-year-old hepatitis B vaccination policy, instead recommending that babies born to mothers who test negative for the virus wait up to two months for their first dose. That change was made without supporting evidence. The CDC director rubber-stamped the decision, though a federal judge has since temporarily blocked it.

Leading medical organizations such as the American Academy of Pediatrics continue to recommend the hepatitis B vaccine within 24 hours of birth. In late April, two analyses published in JAMA Pediatrics underscored medical experts' concerns. Modeling the impact of delay across millions of infants, the studies conclude that every delay scenario resulted in more infections, worse health outcomes and higher health care costs.

The JAMA findings landed alongside a separate troubling trend: a 77% increase between 2017 and 2024 in the share of newborns not receiving the vitamin K shot, a routine intervention that prevents potentially fatal bleeding disorders. To help Minnesota families navigate the conflicting recommendations, I spoke with Dr. Liz Placzek, a pediatrician and senior medical director of pediatrics at Children's Minnesota. Here is my edited conversation with her:

Q: The new guidance from the CDC advisory committee recommends delaying the hepatitis B shot for babies born to mothers who test negative for about two months. Why is it important to give it so soon after birth?

A: Hepatitis B is a virus, and we can come in contact with it in many places. It can live on surfaces for at least seven days, and it only takes a few viral particles - just a very little bit - to become infected. About 95% of adults can fight off or clear the infection. The opposite is true for babies and newborns, where 90% of babies who become infected can't fight off that infection and get a chronic hepatitis B infection, with chronic meaning you have it for the rest of your life. We know that hepatitis B causes liver cancer, liver failure and even premature death. One in four babies who get infected with hepatitis B will die prematurely from liver cancer and liver failure. That's why there's a critical window where we want to provide the protection for those babies to prevent those outcomes.

Q: Can you drill down on why universal vaccination right after birth is still important even if the mother has been screened for hepatitis B?

A: Before 1991, when we started giving the vaccine within 24 hours of birth, we really relied on maternal testing status to get babies the vaccine earlier. But we still kept seeing hepatitis B infections in babies. So we know that screening misses babies and misses moms that were infected. In 1991, the recommendation became universal: Give it within 24 hours. And we saw a 99% decrease in hepatitis B infections in infants.

Q: Are you seeing hesitation in your own clinical practice in Minnesota?

A: I definitely am. We've seen rates of the hepatitis B vaccine uptake decrease over the last few years, and I'm encountering parents with more questions and more hesitation about it. I do want to say, I understand why parents have hesitation about medical intervention in general. These are their babies. They want to keep them safe and healthy, and I welcome having these conversations. But where it gets really difficult is with the massive scope of misinformation.

Q:What do you tell parents who are concerned about the vaccine's safety?

A:Vaccines are one of the most well-studied and monitored medical interventions that we have. Billions of doses of the hepatitis B vaccine have been given for over 30 years. There are no increased side effects if you give the dose at birth as compared to one or two months. So that waiting period really just increases the risk of your baby catching hepatitis B and doesn't decrease any potential adverse effects of the vaccine.

Q: Let's talk about the vitamin K shot. Why is it important?

A:The vitamin K shot gives babies the vitamin K that helps them clot their blood. Without it, they can develop something called vitamin K deficiency bleeding. This isn't relatively minor bleeding like bleeding under the skin or from the umbilical cord - it can also cause really life-threatening brain bleeds or digestive tract bleeds.

Q: Are all infants at risk?

A: All infants are at risk. Vitamin K doesn't pass through the placenta, so babies don't have vitamin K and can't make it themselves yet. Vitamin K from our diet and the bacteria in our gut help our bodies make it - and babies don't have either of those things. So they really need vitamin K after birth.

Q: What does vitamin K deficiency bleeding look like?

A: These are symptoms of a stroke in your baby: increased sleepiness, facial drooping, paralysis of the body - completely devastating and extremely serious. There's no treatment other than giving them vitamin K to help the blood clot. Bleeding into the gut can look like vomiting, a hard belly, blood in their stool, not tolerating food. These babies are really, really sick, and it's completely devastating to see infants affected by vitamin K deficiency bleeding.

Q: Any parting wisdom?

A: Really, the biggest thing I want families to know is that we're seeing unprecedented levels of misinformation - not just about vaccines, but about health care in general. Our job as professionals and pediatricians is to help families navigate that, to answer their question [...] I want them to see the pediatrician's office as a safe place to call with questions. We want to help them. We have their child and their best interests at heart.

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This story was originally published May 12, 2026 at 4:29 AM.