A federal vaccine advisory committee voted Friday to end a longstanding recommendation that all U.S. babies get the hepatitis B vaccine on the day they’re born.

For decades, the government has advised that all babies be vaccinated against the liver infection right after birth. The shots are widely considered to be a public health success for preventing thousands of illnesses.

But U.S. Health Secretary Robert F. Kennedy Jr.’s committee voted to recommend the birth dose only for babies whose mothers test positive or whose infection status is unknown. For other babies, it will be up to the parents and their doctors to decide if a birth dose is appropriate.

For parents who don’t get the birth dose, vaccinations against hepatitis B are advised to start no sooner than 2 months of age.

Some committee members said most babies are at low risk for infection and argued that past studies to look at possible harms from the vaccine were small and potentially inadequate to detect long-term harms. Many medical and doctors groups voiced alarm in anticipation of the vote, saying the concerns were speculative and the decision will mean more children will be infected.

The acting director of the Centers for Disease Control and Prevention, Jim O’Neill, is expected to decide later whether to accept the committee's recommendation.