We listen to the federal Advisory Committee on Immunization Practices (ACIP) meetings to understand proposed changes to CDC immunization recommendations and determine potential updates to the open-source Immunization Calculation Engine (ICE). However, due to changes in the makeup and processes of ACIP, decisions by this body no longer serve as a primary factor in considering changes to the ICE Default Immunization Schedule.
Historically, an ACIP vote to change immunization recommendations represented the culmination of months of work by ACIP members, CDC subject matter experts, and external experts to compile and review the evidence base for a particular recommendation. ACIP meetings served as an opportunity to review details with the full committee, walk through a methodical evidence-to-recommendations framework with considerations across multiple domains, and invite critical feedback and discussion before proceeding with a vote on the immunization guidelines. Ultimately, the process supported informed voting based on a balance of consequences.
ACIP’s December 2025 meeting, similar to their September 2025 meeting (Science for vaccine policy: Independent review of the September 2025 ACIP processes, deliberations and votes), did not follow this protocol. Critically, the ACIP voted to rescind the universal recommendation for all babies to receive a dose of hepatitis B vaccine at birth and to suggest serology testing after each hepatitis B shot (ACIP Meeting Information). On the other hand, a comprehensive review of the evidence for the hepatitis B birth dose found “no benefit related to vaccine safety or protection of a delayed first dose compared with vaccination at birth, but identified critical risks of changing current US recommendations.” (Universal Hepatitis В Vaccination at Birth: Safety, Effectiveness, and Public Health Impact, Vaccine Integrity Project). Additionally, in response to the ACIP vote, several medical societies indicated that the ACIP decision “will lead to more chronic infections that will follow patients into adulthood, and will complicate vaccine access for children. No new data was presented during the ACIP meeting to justify this change” (Statement from Leading Medical, Health and Patient Advocacy Groups on CDC Vaccine Meeting).
HLN remains committed to delivering evidence-based recommendations in the open-source ICE software, in line with guidelines from the professional medical societies and based on feedback from the ICE Advisory Group. This includes maintaining the existing support for the Hepatitis B birth dose and Hepatitis B series completion in the ICE Default Immunization Schedule.
For more information about ICE and/or the ICE Advisory Group, or if your organization has specific requirements that differ from the ICE default schedule, please reach out to us at ice@hln.com for assistance.