The Hepatitis B Grift

Tomorrow, ACIP will consider what dozens of countries figured out long ago

WASHINGTON, District of Columbia—Tomorrow, the Advisory Committee on Immunization Practices (ACIP) will meet to discuss something that should have been reconsidered decades ago: the recommendation that every single American newborn receive a hepatitis B vaccine within 24 hours of birth.

Let me be clear from the start: I have no problem with vaccinating babies who are actually at risk—those born to mothers who test positive for hepatitis B. That makes sense. What doesn’t make sense is jabbing millions of newborns whose mothers have already tested negative, based on a policy that most of the developed world rejected long ago.

The data is hiding in plain sight. And it’s devastating to the universal birth dose position.

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What Europe Knows That We Pretend Not To

Here’s a fact that should stop every American parent in their tracks: Denmark, Finland, Iceland, and Sweden do not recommend universal hepatitis B vaccination for children at all. Not at birth. Not at two months. Not ever—unless the child is at risk.

These aren’t developing nations struggling with disease control. These are among the healthiest countries on Earth. Their children aren’t dying of hepatitis B. They aren’t having a hepatitis B crisis. The disease is essentially a non-issue in their pediatric populations.

How do they manage this? It’s elegantly simple:

1. Screen pregnant women for hepatitis B

2. Vaccinate babies born to positive mothers at birth

3. That’s it

The result? Exposed infants are protected. Low-risk infants aren’t subjected to an unnecessary medical intervention in their first hours of life. Everyone wins.

The prevalence of hepatitis B in Scandinavian countries? 0.05% to 0.2%—among the lowest rates on the planet. Denmark’s rate is approximately 0.55%. Finland’s is 0.2%. These numbers haven’t budged despite decades of not vaccinating every single newborn.

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The Numbers Are Staggering

Let’s talk about what the European data actually shows.

In the European Union and European Economic Area, 27 out of 30 countries recommend childhood hepatitis B vaccination. But here’s the kicker: only 5 countries recommend a universal birth dose for all infants. That’s it. Five.

The other 25 countries? They give the birth dose selectively—only to babies born to hepatitis B positive mothers.

Think about that for a moment. Twenty-five European nations with universal healthcare, robust public health systems, and meticulous health tracking have looked at the evidence and concluded: universal birth dose vaccination is unnecessary.

These aren’t anti-vaccine countries. They vaccinate for everything else. They simply determined that vaccinating a one-day-old baby for a disease their mother doesn’t have—a disease primarily transmitted through sex and IV drug use—makes no medical sense.

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The “Safety Net” Argument Falls Apart

The CDC will tell you that universal birth dose vaccination provides a “safety net” for babies whose mothers weren’t properly screened or whose status is unknown. This sounds reasonable until you look at comparable countries.

In the EU/EEA countries that use selective birth dose vaccination, over 90% of pregnant women are screened for hepatitis B. In several countries, it’s approaching 100%. The “missed mothers” argument might have made sense in 1991 when universal birth dose was first recommended, but it’s 2025. We have the infrastructure to screen mothers. We’re already doing it.

The countries using selective vaccination aren’t experiencing waves of hepatitis B in children due to “missed” mothers. It’s simply not happening.

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Who Actually Gets Hepatitis B?

Let’s talk about transmission, because this is where the policy falls apart completely.

Hepatitis B is transmitted through:

• Sexual contact with an infected person

• Sharing needles

• Mother-to-child transmission at birth

• Blood transfusions (rare in developed countries with screening)

A one-day-old baby born to a hepatitis B negative mother has exactly zero of these risk factors. None. The baby isn’t having sex. The baby isn’t using IV drugs. The mother has already been screened.

So why are we vaccinating that baby within 24 hours of birth?

The answer isn’t medicine. The answer is policy inertia and liability avoidance. Once a recommendation is made, it takes an act of Congress to undo it—even when the rest of the developed world has shown us a better way.

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Follow the Money

Let’s talk about what nobody in public health wants to discuss: the economics.

In 2024, there were 3,628,934 births in the United States. Every single one of those babies—regardless of whether their mother tested positive or negative for hepatitis B—received a hepatitis B vaccine within 24 hours of birth. At private sector pricing of approximately $62 per dose for Engerix-B or Recombivax HB, that’s over $225 million per year—just for the birth dose.

But it doesn’t stop there. The birth dose is the first of a three-dose series. Once you start the series at birth, you continue it at 1-2 months and 6-18 months. So that initial birth dose triggers roughly $670 million in total hepatitis B vaccine revenue for American newborns annually.

The U.S. hepatitis B vaccine market was valued at $2.5 billion in 2024. North America dominates the global hepatitis B vaccine market with over 40% market share. And the market is projected to keep growing—reaching $4.7 billion by 2034.

GlaxoSmithKline (Engerix-B), Merck (Recombivax HB), and Dynavax (Heplisav-B) aren’t exactly disinterested parties when ACIP meets to discuss vaccination policy. These companies have built substantial revenue streams around a recommendation that most of the developed world has rejected.

Meanwhile, Denmark, Finland, and Sweden haven’t collapsed into a hepatitis B crisis. Their children are fine. Their selective approach works. But their approach doesn’t generate hundreds of millions in annual revenue for pharmaceutical companies.

When a policy generates this much money, removing it requires overcoming enormous institutional inertia—and some very well-funded lobbying efforts.

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“But What About Later Exposure?”

Some will argue that children might be exposed later in life—through household contacts, or eventually through sexual activity or other means. Fine. Let’s look at what countries do about this.

Many European countries that don’t give a birth dose still include hepatitis B in their childhood vaccination schedule—just at 6 weeks or 2 months, as part of combination vaccines. Others vaccinate adolescents before they become sexually active. Hungary, for instance, vaccinates at age 12.

The point isn’t that hepatitis B vaccination has no value. The point is that vaccinating a 12-hour-old baby for a disease they cannot possibly contract at that moment, when their mother has already tested negative, is medical theater—not evidence-based medicine.

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The Real Question

Here’s what I want you to ask yourself: If Denmark, Finland, Iceland, Sweden, and dozens of other European nations can protect their children from hepatitis B without vaccinating every newborn, why can’t we?

These countries have:

• Lower rates of hepatitis B than the United States

• Universal healthcare that tracks outcomes meticulously

• No hepatitis B crisis in children

• Exposed infants who ARE vaccinated at birth

Their approach is working. Exposed babies are protected. Unexposed babies aren’t subjected to an unnecessary intervention. The data spans decades and hundreds of millions of children.

What exactly is the American medical establishment afraid of? That we might align our policies with the evidence? That we might follow the example of some of the healthiest nations on Earth?

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What Tomorrow Should Bring

Tomorrow, ACIP has an opportunity to do something rare in American public health: admit that a one-size-fits-all policy doesn’t fit all.

The recommendation should be simple, and it should mirror what works in Europe:

1. Universal screening of pregnant women for hepatitis B (we’re already doing this)

2. Birth dose vaccination for infants born to positive mothers (no argument here)

3. Remove the recommendation for universal birth dose in infants born to negative mothers

This isn’t radical. This isn’t “anti-vaccine.” This is what Denmark does. This is what Finland does. This is what the majority of European nations do.

The only thing standing in the way is institutional pride—the unwillingness to admit that maybe, just maybe, the Europeans got this one right and we got it wrong.

Thirty-four years of vaccinating every American newborn for a disease most of them cannot possibly have at birth. Hundreds of millions of unnecessary doses. Over $225 million per year flowing to pharmaceutical companies for birth doses alone. And for what? Outcomes that are no better than countries that take a targeted approach.

Tomorrow, we’ll find out if ACIP has the courage to follow the evidence—or if the hepatitis B grift continues for another generation of American newborns.

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About the author

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J.B. Handley is the proud father of a child with Autism. He spent his career in the private equity industry and received his undergraduate degree with honors from Stanford University. His first book, How to End the Autism Epidemic, was published in September 2018. The book has sold more than 75,000 copies, was an NPD Bookscan and Publisher’s Weekly Bestseller, broke the Top 40 on Amazon, and has more than 1,000 Five-star reviews. Mr. Handley and his nonspeaking son are also the authors of Underestimated: An Autism Miracle and co-produced the film SPELLERS, available now on YouTube.