A coalition of vaccine scientists released a comprehensive review supporting universal hepatitis B vaccination within 24 hours of birth, submitting the evidence days ahead of a pivotal CDC advisory vote on changing timing. The review pooled data from over 400 studies and concluded neonatal dosing has reduced pediatric infections by more than 95%. The release comes as the FDA and CDC face internal policy shifts—driven by recent leadership memos—that could alter vaccine approval and use frameworks. Public-health experts warn delaying the hep B dose could increase avoidable chronic infections; a modeling preprint projected thousands of additional chronic cases if the first dose were shifted later in infancy. Clinicians, vaccine program managers, and manufacturers should prepare for policy volatility and potential operational changes to neonatal immunization workflows depending on the advisory panel’s decision.