The Advisory Committee on Immunization Practices voted to remove the longstanding universal recommendation that newborns receive the first hepatitis B vaccine dose at birth, adopting a new guidance that parents consult clinicians when mothers test negative. The vote passed 8-3 after hours of debate and follows a series of contentious ACIP meetings this year. Public-health groups and pediatric infectious-disease experts warned the change reduces early protection for infants; ACIP members argued low-risk newborns and parental choice justify the shift. The guidance recommends initiating the three-dose regimen no earlier than two months for infants of mothers who test negative for HBV. For context: the birth dose has been the CDC standard to prevent perinatal transmission and early-life infection.