Should Newborns Receive the Hepatitis B Vaccine?
This topic is on the agenda for an upcoming meeting of the CDC Advisory Committee on Immunization Practices (ACIP) scheduled for Thursday. The influential panel is likely to vote on delaying the hepatitis B vaccination that is typically given at birth, pushing it instead to ages up to four. NPR has reported on this development.
Demetre Daskalakis, a former director of the National Center for Immunity and Respiratory Diseases, mentioned, “There will be discussions surrounding the hepatitis B vaccine. The goal is to reduce the number of doses given at birth and recommend them for later.” He expressed that this seems to be a priority for the Health Secretary.
Health Secretary Robert F. Kennedy Jr. has historically been skeptical about vaccines. Notably, he dismissed all 17 ACIP members in June and plans to re-evaluate recommendations for the COVID-19 vaccine during this significant meeting.
Hepatitis B is a viral infection and recognized as a leading cause of liver cancer globally, among other serious health issues.
How Prevalent Is Hepatitis B?
Chronic hepatitis B affects over 296 million people globally, making it the most common liver infection. In the U.S., around 2.4 million people may have chronic cases.
The virus can become chronic if the immune system doesn’t eliminate it within six months after infection. In 2023, there were about 17,650 new cases and 1,769 deaths associated with hepatitis B, according to the CDC. About 2,200 new acute infections were also noted this year.
Interestingly, many individuals are unaware that they are infected, and a significant portion has not been tested for the virus. The rate of hepatitis B in the U.S. saw a marked decline once the Universal Infant Vaccination Program was initiated in 1991.
How Does Hepatitis B Spread?
The virus transmits primarily via contact with infected blood or body fluids. Common transmission routes include intimate contact, sharing needles, and from mother to child during childbirth. Expectant mothers typically undergo screening for hepatitis B early in their pregnancy.
If a mother tests positive for the virus, she might receive antiviral treatment in her later pregnancy stages. Her newborn is then given the hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) shortly after birth.
While there’s no cure for hepatitis B, around 95% of adults are able to clear the virus naturally within approximately six months. Failure to manage chronic hepatitis B can lead to liver damage or even cancer.
Children face a higher risk of long-term complications; nearly 90% of infants infected during birth may develop chronic illness.
What Are the Vaccination Recommendations?
In 1991, the ACIP recommended universal vaccination for all infants. The first dose should ideally be administered within 24 hours after birth, with a second dose at 1-2 months, and a final dose between 6 and 18 months. This vaccination approach protects about 98% of healthy infants, according to CDC guidelines.
Possible mild side effects, which typically resolve quickly, might include soreness, redness, headaches, and fatigue at the injection site.
The American Academy of Pediatrics noted in June that while the U.S. has made significant strides in reducing perinatal hepatitis B, moving away from administering the vaccine at birth could jeopardize this progress.
