The Human and Financial Costs of Delaying Vaccines

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) was scheduled to meet February 25-27 to further discuss childhood vaccine schedules. It remains to be seen if the committee will meet on those dates or reschedule. Considering the massive changes and confusion sown in recent meetings, there are concerns that this committee, which has demonstrated an antivaccine ideology, could erode confidence further in vaccines.

One of the ideologies this committee has put forth is the idea of looking at a risk-based approach to vaccines—without any data—compared with the universal approach, which has been in use for several years. The latter approach has been considered a public health success, especially because vaccine-preventable diseases have decreased over the years.

One such example is the universal birth dose of the hepatitis B vaccine given to all children within 24 hours of birth. Their second dose is administered at 1 to 2 months, and their third dose at 6 to 18 months. Prior to the universal birth dose recommendation, approximately 18,000 children a year in the US were infected with hepatitis B before they reached the age of 10 years.¹

“Many people in public health viewed the now previously recommended universal birth dose approach as a way to help ensure we're capturing all and protecting all the infants who need protection against potential risk of infection,” said Eric Hall, PhD, MPH, assistant professor of epidemiology at the Oregon Health & Science University/Portland State University School of Public Health.

Last year, Hall led a study that was formed from a research collaboration with HepVu, the Hepatitis B Foundation, and the National Viral Hepatitis Roundtable, which resulted in an analysis that demonstrated the potential health care and financial costs of delaying the universal birth dose.

Some of the investigators’ findings included:

• By delaying the birth dose to 2 months among infants whose mothers are not known to be living with hepatitis B, there could be at least 1400 preventable hepatitis B infections among children, 300 excess cases of liver cancer, 480 preventable deaths, and over $222 million in excess health care costs for each year the revised recommendation is in place.²
• If the birth dose were delayed to 12 years, this would balloon to at least 2700 preventable hepatitis B infections for each year the revised recommendation is in place.²

Health Care Costs

By delaying vaccines, health care spending due to new infections and lifelong management of chronic hepatitis B infection and liver disease increases. For each year the delayed birth dose policy is in place for infants whose mothers have negative test results for hepatitis B, the following potential costs could be realized:

• Delaying the birth dose to 2 months results in at least $21.6 million in health care costs.
• Delaying to 7 months results in at least $24.5 million.
• Delaying to 4 years results in at least $24.6 million.
• Delaying to 12 years results in at least $27.5 million.²

It remains to be seen what will happen during the ACIP meetings next week, but thus far, Hall says the fracture between the federal regulatory bodies and medical professional societies is an example of how badly the atmosphere of public health has eroded. He says all this back-and-forth without clear guidance will lead to further public uncertainty about vaccines and that it will mean fewer children being vaccinated.

“I think that the potential erosion of public confidence and confusion are my top concerns,” Hall said.

References
1. Why we give hepatitis B vaccines to infants. National Foundation for Infectious Diseases. October 20, 2025. Accessed February 17, 2026. https://www.nfid.org/why-we-give-hepatitis-b-vaccines-to-infants/
2. New analysis shows delaying the hepatitis B birth dose may lead to thousands of preventable infections and hundreds of millions in avoidable healthcare costs. HepVu. December 1, 2025. Accessed December 2, 2025. https://hepvu.org/news-updates/new-analysis-shows-delaying-the-hepatitis-b-birth-dose-may-lead-to-thousands-of-preventable-infections-and-hundreds-of-millions-in-avoidable-healthcare-costs/