Most Democratic-led states say they will continue to universally recommend and administer the hepatitis B vaccine at birth, despite novel guidelines against it issued last week by a federal vaccine advisory panel handpicked by Health and Human Services Secretary Robert F. Kennedy Jr.
The Northeast Public Health Collaborative and West Coast Health Alliance, which formed earlier this year in response to Kennedy’s vaccine policy change, along with other blue states plan to defy the latest recommendations from the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, or ACIP.
Hepatitis B is a solemn, incurable infection that can lead to liver damage and liver cancer. It can be passed from mother to child during childbirth and without vaccination, about 90 percent of infants Those infected from birth develop chronic hepatitis B infection. Among people with chronic infection, 25 percent will die prematurely from the disease.
Since 1991, ACIP and the American Academy of Pediatrics have recommended universal hepatitis B vaccine doses within 24 hours after birth. The sooner a newborn is vaccinated, the greater the chance of avoiding chronic infection. The birth dose is credited with dramatically reducing the rate of infection in children. However, last week Kennedy’s newly formed ACIP, which includes some vaccine skepticsoverturned this 30-year precedent. In June, Kennedy announced “clean sweeping” ACIP, removing all 17 existing experts and replacing them with novel members of its own choosing.
During a messy two-day meeting riddled with misinformation, the committee voted to recommend the hepatitis B vaccine at birth only for infants born to pregnant women who test positive for the virus or whose status is unknown. For people who test negative for hepatitis B, the panel recommended “case-by-case decision-making,” meaning parents should talk to doctors about vaccinations first. If a baby does not receive the first dose after birth, the panel suggests delaying the first dose until the baby is at least two months aged.
Medical experts condemned the decision, saying screening in the U.S. is imperfect and cannot detect all infections. Half the people who have it they don’t know they are infected.
“In the United States, there have been several versions of the hepatitis B vaccine recommendation, all based on risk. We tried to study mothers, we tried to vaccinate only babies born to mothers with hepatitis B, and they all failed. The universal birth dose was the ultimate success and the reason why since its implementation, the number of cases of hepatitis B in children has dropped by 99 percent,” says Michaela Jackson, director of prevention policy at the Hepatitis B Foundation.