Current US guidelines call for universal hepatitis B vaccination of newborn babies.Credit: Hyoung Chang/The Denver Post/Getty
Members of a top US vaccine advisory panel voted today to roll back a decades-old recommendation that all newborns receive a hepatitis B vaccine shortly after birth — a measure that has been associated with a sharp decline in mother-to-child transmission of the hepatitis B virus, which causes liver disease.
Newborn vaccination is still recommended for babies born to mothers who have tested positive for the virus, or whose mothers’ infection status is unknown. But for babies born to mothers who have tested negative for the hepatitis B virus, the US Advisory Committee on Immunization Practices (ACIP) now recommends that decisions be made individually – and suggests that babies who do not receive a ‘birth dose’ of the vaccine be vaccinated no earlier than the age of two months.
Recommendations made by the ACIP must be approved by the director of the US Centers for Disease Control and Prevention (CDC) before they become official policy of the agency.
The vote came after more than a day of discussion that was at times confused and contentious. Several members of the panel have previously expressed broad criticism of vaccines, and continued to do so at this week’s meeting.
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“What we are doing here is trying to undo some really, really bad decision processes we had in the past,” said ACIP member Retsef Levi, a professor of operations management at the Massachusetts Institute of Technology in Cambridge, who pointed to what he considers to be gaps in the data about the vaccine’s safety.
But other ACIP members expressed concern that the new recommendations were not grounded in data, and could cause harm. “To make the change that is proposed, we will see more children and adolescents and adults infected with hepatitis B,” said Cody Meissner, an ACIP member and a paediatrics researcher at the Geisel School of Medicine at Dartmouth in Lebanon, New Hampshire. He repeatedly argued that studies have shown the hepatitis B vaccine to be safe.
Several public commenters at the meeting also pointed to data indicating that the vaccine is safe. And Rochelle Walensky, who directed the CDC from 2021 to 2023 and is now a professor of medicine at Harvard Medical School in Boston, Massachusetts, noted at a media briefing Thursday that US vaccine-safety monitoring system can detect “very, very rare” safety events. “Over 35 years, with a huge amount of experience and millions of doses given, we have not detected those events”, she said.
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