The American Association for the Study of Liver Diseases (AASLD) and its undersigned partner organizations - the American College of Gastroenterology (ACG), the American Gastroenterological Association (AGA), the American Society for Gastrointestinal Endoscopy (ASGE), the Infectious Diseases Society of America (IDSA), and the North American Society for Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN) - are alarmed by the 8-3 vote by the Advisory Committee on Immunization Practices (ACIP) to abandon the recommendation to initiate universal hepatitis B vaccination immediately after birth. Relying on the hepatitis B status of the infant's mother to determine whether the birth dose is appropriate creates confusion and ambiguity for new parents, the community, and medical professionals when the evidence clearly supports the safety and effectiveness in providing lifetime protection of administering a universal birth dose after consultation between an infant's parents and their health care provider.