ACIP voted 8-3 to drop universal hepatitis B vaccination at birth in favor of targeted immunization for infants born to hepatitis B–positive mothers or with unknown maternal status, a decision supported by Jim O'Neill.The panel said the birth dose should still be given to infants with infected or unknown mothers while others would begin the series no earlier than two months of age after parental consultation, and Bay Area aligned with the decision.Donald Trump publicly supported the move, signed a memo to review child immunization guidelines to align standards with peer countries and directed a global review of vaccine schedules while critics including AAP and NYSDOH warned that maintaining universal vaccination remains the safest course to prevent chronic hepatitis B.