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Under-vaccination as a systems failure: A Monte Carlo simulation of the 2025 CDC/ACIP hepatitis B birth-dose policy shift and multi-level intervention packages, 2025–2035
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DOI：10.1016/j.vaccine.2026.128883.png)
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Abstract
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In 2025, the CDC/ACIP reclassified the hepatitis B (HBV) birth-dose recommendation from universal vaccination to a shared clinical decision-making (SCDM) model. U.S. adult HBV vaccination rates remain stagnant at 30–32%, reflecting systemic delivery failures. The projected impact of this policy shift and whether multi-level interventions can protect vulnerable populations remains unquantified.
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