Experts, Policymakers Highlight Concerns Over Future Access to Hepatitis B Immunization

This year, the newly reconstituted Advisory Committee on Immunization Practices (ACIP) and supporters within the Make America Health Again (MAHA) movement are challenging – even ignoring – decades of established evidence and seeking to reverse or delay the Hepatitis B (Hep B) birth-dose policy.

Hep B is a serious liver infection transmitted through blood, body fluids, and even casual contact. Infants and young children are at highest risk of developing chronic infection. The Hep B vaccine, which has been used for over 40 years, and has been extensively studied, is currently recommended for all newborns within 24 hours of birth to prevent perinatal transmission and protect infants from household exposures when they are most vulnerable.

Without the protection of a vaccine, an infant or child who contracts Hep B risks a 90 percent chance of going on to develop chronic hepatitis, which can cause serious life-long complications. Despite this risk of harm, ACIP and MAHA supporters argue that immunization should be postponed, and the committee could vote on a new recommendation at its next meeting, which has yet to be rescheduled.

Since implementation of the recommended vaccine dose at birth, infant infections with Hep B have declined by 95 percent. Before this recommendation, the vaccine was given only to babies at high risk of contracting Hep B and yet rates of infection remained stubbornly high. It wasn’t until the universal birth dose did rates plummet. When given within 24 hours of birth, the Hep B vaccine is 90 percent effective at preventing infection.

Leading public health specialists and experts have voiced strong opposition to these changed, underscoring the importance of preserving the birth dose, including:

Dr. Jesse Goodman, former FDA chief scientist and CBER director: "Before the birth dose of Hep B was in place tens of thousands of children were infected as newborns or infants and that was reduced by over 90%. So that's been policy now for 30 years or so. Why are we suddenly overturning that - people should really ask what is the evidence for that.”

Dr. Tina Tan, pediatric infectious diseases physician and president of the Infectious Disease Society of America: “These are not benign diseases, everything that we vaccinate against basically is a serious disease and vaccines are the best way to prevent that from happening. You know if you look at something like hepatitis B and they're talking about oh don't give the vaccine to people. Hepatitis B can cause serious liver disease and liver cancer. It is an anti-cancer vaccine so all this misinformation that is coming out from the current ACIP is really putting all of us and America at significant risk, and that is a major problem.”

Sen. Lisa Blunt Rochester (D-DE): “It is my understanding that before 1991, when not all babies were vaccinated, about 20,000 babies were infected each year. And that after the CDC recommendations in the 1990s that dropped by 99%. This terribly contagious disease, and the reason why we test everybody is because certain moms might not have been tested and don’t know that they have it.”

Sen. Bill Cassidy (R-LA), Senate HELP Committee Chair: “In the decade following the approval of the birth dose of hepatitis B, newborn infection of hepatitis B reduced by 68% [by 2001]. Now, fewer than 20 babies per year get hepatitis B from their mother. That is an accomplishment to make America healthy again and we should stand up and salute the people that made that decision. Because those people who would otherwise be dead if their mothers were not given the option to have their child vaccinated.”

Debra Houry, former CDC Chief Medical Officer: “I was an ER doc…It’s that first year of life where, if a baby is infected, they’re going to have the worst outcomes with a hepatitis infection, and that’s why it’s really important to give it early on…I’m really concerned, because if people have increased vaccine hesitancy, if we don’t have the platforms like mRNA to develop vaccines, we’re not going to be prepared…I fear for public health in our country.”

Adam Langer, acting Principal Deputy Director and Associate Director for Science at CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention: “Hepatitis B vaccination is the cornerstone of hepatitis B prevention and control. And the sooner that the hepatitis B vaccine is provided after birth, the greater its effectiveness in preventing perinatal transmission…The current recommendation is to start the hepatitis B series on the very first day of life because there are important benefits even among infants born to test negative mothers and there is no evidence that the risk of already rare adverse events is any greater among newborns than among older infants.”

With overwhelming evidence and decades of success behind the current policy, public health leaders urge ACIP to stay the course and protect America’s youngest from a virus that once claimed thousands of lives each year.

Learn more about hepatitis vaccines here.