The U.S. Centers for Disease Control and Prevention adopted new ACIP recommendations that remove the longstanding universal hepatitis B birth‑dose guidance, shifting to an individualized, risk‑based approach for newborn immunization. The agency formalized the Advisory Committee on Immunization Practices’ decision in a policy update. Under the new recommendations, clinicians will weigh maternal testing and individual risk factors rather than automatically administering a birth dose to all infants. CDC and ACIP framed the change as aligning immunization with current testing and risk‑stratification capabilities. The shift reverses decades of practice and will prompt updates to hospital delivery‑room workflows, state immunization schedules, and perinatal counseling. Public‑health groups and pediatric infectious‑disease specialists are likely to track early implementation and its effects on HBV transmission rates.