AASLD Backs Ruling Blocking Changes to Childhood Vaccine Schedule | Healio

The American Association for the Study of Liver Diseases (AASLD) has voiced its support for a recent court ruling that temporarily halts changes to the recommended childhood and adolescent immunization schedule in the United States, specifically regarding hepatitis A and B vaccinations. This decision comes after months of advocacy from the AASLD and other medical organizations concerned about potential repercussions from altering established vaccination protocols.

Protecting Preventative Measures

The ruling, issued by U.S. District Judge Brian E. Murphy on March 16, 2026, blocks modifications made by the Trump administration to the Centers for Disease Control and Prevention’s (CDC) evidence-based childhood vaccine schedule. These changes included removing the universal recommendation for a hepatitis B (HBV) birth dose and shifting to risk-based recommendations for routine hepatitis A (HAV) vaccination in infants and children. The original recommendations called for universal vaccination, meaning all infants and children would receive the vaccine regardless of specific risk factors. The revised approach proposed vaccination only for those with increased exposure or existing comorbidities.

“We are at a critical inflection point for vaccine policy in the United States, particularly for hepatitis,” explained Saul J. Karpen, MD, PhD, FAASLD, president of AASLD and inaugural chief scientific officer for the Stravitz-Sanyal Institute for Liver Disease and Metabolic Health at Virginia Commonwealth University. “If the vaccine schedule changes were ultimately implemented, the consequences may not be instantaneous but will accumulate and, in a few months and certainly years, will be problematic and potentially irreversible.”

Potential Consequences of Altered Schedules

The AASLD’s concerns center around the potential for increased rates of hepatitis A and B infections, and the subsequent development of more severe liver disease. Dr. Karpen highlighted that altering the vaccination schedule could shift the focus from prevention to managing more advanced and complex cases of viral hepatitis. This could lead to a rise in chronic infections, liver failure, and an increased demand for liver transplantation. Chronic viral hepatitis represents a significant public health challenge, and preventative measures like vaccination are crucial for controlling its spread.

Specifically regarding the HBV birth dose, Dr. Karpen emphasized its effectiveness in preventing mother-to-child transmission. Removing or delaying this protection leaves newborns vulnerable at a critical time. Acquiring hepatitis B at a young age can lead to a lifelong trajectory toward cirrhosis, liver failure, and liver cancer.

The situation with the HAV vaccine is also concerning. Following the introduction of the vaccine in 1996, cases of hepatitis A dropped by over 95% until 2016. However, the CDC reported a resurgence of the disease after that point, demonstrating the importance of maintaining high vaccination rates. Maintaining routine HAV vaccination is seen as essential for protecting vulnerable populations.

AASLD’s Advocacy and the Broader Context

The AASLD’s support for the court ruling is the culmination of months of advocacy efforts. Throughout 2025, the organization engaged with federal leaders, submitted formal policy comments, and collaborated with other U.S.-based patient and healthcare organizations to raise concerns about the proposed changes. This advocacy aligns with broader efforts within the medical community, including a lawsuit filed by the American Academy of Pediatrics and other medical societies in summer 2025 to challenge the changes to both the COVID-19 and childhood vaccine schedules. The lawsuit sought to halt the implementation of the novel recommendations.

Dr. Karpen underscored the foundational role of vaccines in preventing liver disease. “Vaccines are one of the most effective tools we have in all of medicine, and in hepatology, they are foundational to prevention,” he stated. “Infants rely on us to protect them at their most vulnerable. When those protections are weakened, it’s not just a change in policy; it will likely put an entire generation at risk for preventable, lifelong liver disease.”

Looking Ahead: Continued Vigilance and Monitoring

The temporary block provides a period for further review and consideration of the proposed changes to the CDC’s vaccine schedule. The court’s decision does not necessarily represent a permanent rejection of the modifications, but rather a pause to allow for a more thorough evaluation of the potential consequences. The AASLD and other stakeholders will likely continue to monitor the situation closely and advocate for evidence-based vaccination policies.

The process of updating vaccination schedules is complex and involves careful consideration of scientific data, public health priorities, and potential risks and benefits. Ongoing surveillance of hepatitis A and B infection rates, as well as continued research into vaccine effectiveness and safety, will be crucial for informing future guidance. Clinicians should stay informed about the latest recommendations from the CDC and other authoritative sources to ensure they are providing the best possible care to their patients.

Saul J. Karpen, MD, PhD, FAASLD, can be reached at [email protected].