Federal vaccine advisory panel votes to end recommendation that all newborns be vaccinated against hepatitis B
Northeastern experts say the reason hepatitis B cases have plummeted is due to a vaccination schedule in place for 30 years
A federal vaccine advisory panel voted Friday to end its decades-old recommendation that all babies be vaccinated at birth against hepatitis B.
The Advisory Committee on Immunization Practices, or ACIP, continues to recommend the shots for infants of mothers who test positive for the virus or whose status is unknown.
But the committee voted 8-3 that women who test negative consult with their health care provider and “decide when or if their child will” be vaccinated at birth, according to the New York Times.
The hepatitis B vaccine is typically given in a series of three shots. Northeastern University professors of public health and public health law said they are worried disruptions to the vaccination schedule will make a new generation of children susceptible to debilitating and possibly fatal liver disease.
“For over 30 years, the hepatitis B vaccine has proven to be very safe, very effective,” said Neil Maniar, director of the master of public health program at Northeastern.
The change will put more individuals at risk for an illness that is hard to detect, incurable when chronic and a risk factor for liver cancer, he said. “Since we implemented the hepatitis B vaccine recommendation, we’ve probably reduced the likelihood of liver cancer in infants and young children by about 95%.”
The World Health Organization says that globally, 254 million people were living with a chronic hepatitis B infection in 2022, with 1.2 million new infections each year.
In the U.S., there were 17,650 newly reported chronic cases in 2023 and an estimated 14,400 new acute cases of the virus, according to the Centers for Disease Control and Prevention, or CDC.
“Vaccination has probably prevented about 6 million infections and about a million hospitalizations,” Maniar said.
Taking the first shot out of a hospital birth setting would make it more difficult for some parents to access the hepatitis B vaccine, which means some children who would not have developed hepatitis B might do so, said Wendy Parmet, a leading expert on public health law.
“It will require more medical appointments,” she said. “And not everybody has access to or can afford going to a pediatrician.”
Parmet and Maniar said the vote was a win for Health and Human Services Secretary Robert F. Kennedy Jr., who this year fired all 17 ACIP members, replacing some panelists with vaccine skeptics.
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Kennedy has cut funds for mRNA vaccine research and wrote an op-ed challenging a Danish study that found no link between aluminum in vaccines and childhood disorders, saying it was “meticulously designed” not to find harm. In November, the CDC, over which Kennedy has oversight, changed language on its website to say the scientific consensus that vaccines do not cause autism “is not an evidence-based claim.”
During the two-day ACIP meeting that ended Friday, Dr. Tracy Beth Hoeg, the new acting director of the Center for Drug Evaluation and Research, said the U.S. is an outlier among high-income nations in recommending a birth dose of hepatitis B vaccine at birth to infants of mothers who tested negative for the virus.
She said she agreed with ACIP member Retsef Levi, who questioned whether the side effects from the shot have been adequately reported.
“We need to be humble when we say the benefits outweigh the risks,” Hoeg said.
Hepatitis B can be transmitted during birth and needle sharing. It can also be sexually transmitted, one reason Kennedy “has intimated that we do not need universal protection,” Parmet said.
But people can also contract the virus from contact with infected blood on a razor blade, toothbrush or other surfaces, Maniar said.
“It takes just a couple of droplets of blood to transmit the virus,” he said.
Dr. Amy Middleman, a representative of the Society for Adolescent Health and Medicine, told ACIP members that she opposed weakening the birth dose recommendation out of concern some children would fall through the cracks of an “imperfect” health care system and become infected with hepatitis B.
The new recommendation was the first time in her 21 years as a liaison to ACIP that its policy “actually puts children in this country at higher risk rather than lower risk of disease and death,” Middleman said.
ACIP members recommended that mothers who test negative for the virus vaccinate their children no earlier than two months of age.
The reason people do not see as much hepatitis B anymore, especially in children, is because of vaccination, Maniar said.
“Once we take our foot off the pedal, we are likely to see an increase in these infections,” he said.
