A federal vaccine advisory committee in the US is set to decide on whether newborns should still get the hepatitis B vaccine — the first shot found to prevent cancer.
The CDC advisory group is expected to change the guidance that has been in place since the early 1990s, under which the hepatitis B vaccine was administered within the first 24 hours of life.
What is Hepatitis B?
Hepatitis B is a serious liver infection that for most people lasts less than six months. But for some — especially infants and children — it can become a long-lasting problem that can lead to liver failure, liver cancer and scarring called cirrhosis.
In adults, the virus is spread through sex or through sharing needles during injection drug use.
But it can also be passed from an infected mother to a baby. As many as 90% of infants who contract hepatitis B go on to have chronic infections, meaning their immune systems don’t completely clear the virus.
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As many as 2.4 million people in the U.S. are estimated to have hepatitis B, and as many as half are unaware they are infected, according to information from the Centres for Disease Control and Prevention.
Hepatitis B vaccine for newborns
For decades, the US vaccine guidance has been influenced by a government-appointed panel of experts, the Advisory Committee on Immunisation Practices. Its recommendations have usually been adopted as national guidance that is widely heeded by doctors.
In 1991, the committee recommended an initial dose of hepatitis B vaccine at birth. The guidance was modified a little over the years and currently suggests a dose within 24 hours of birth for all medically stable infants who weigh at least 2 kilograms, plus follow-up shots to be given at about 1 month and 6 months.
Why a dose right at birth?
Health officials used to rely on screening expectant mothers to find babies that might have been exposed to the virus. But many cases were missed, experts say, because some women weren’t tested or test results were incorrect. Also, the virus can live on surfaces for more than seven days at room temperature, so unvaccinated children living with a person with a chronic infection can catch it.
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Newborn hepatitis B vaccinations are widely considered to be a public health success story. Over about 30 years, cases among children fell from about 18,000 per year to about 2,200. According to a study published this week, which analysed than 400 studies and reports spanning 40 years, birth dose is safe, and is an important reason US pediatric hepatitis B infections have fallen.
Why the guidelines may change
US Health Secretary Robert F. Kennedy Jr has been a leading anti-vaccine activist before becoming the nation’s top health official.
Kennedy fired all 17 members of ACIP earlier this year and replaced them with a group that includes several anti-vaccine voices. The new panel has raised concerns about giving a vaccine to a baby so early in life.
“Are we asking our babies to solve an adult problem?” Dr. Evelyn Griffin, one of the committee members, had asked at a September meeting.
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“The signal that is prompting this is not one of safety. It’s one of trust. … It’s one of parents uncomfortable with this medical procedure being performed at birth in a rather unilateral fashion without significant informed consent,” another committee member Dr. Robert Malonem, had said.
Impact of delayed vaccination
According to health researchers, delaying the birth dose to 2 months could result in at least 1,400 hepatitis B infections in children and 480 deaths. They also warned that the estimated toll would be higher if the first dose were given even later.
