The Centers for Disease Control and Prevention vaccine advisory council recommended delaying the first dose of the hepatitis B vaccine for newborns.
Previously, the first dose would be administered within 24 hours of birth. The advisory panel decided after an 8-3 vote on Dec. 5 to recommend immediate newborn vaccination only if the mother tested positive for hepatitis B or if her infectious status is unknown. For mothers who tested negative, the vaccine should be administered no earlier than two months after the baby is born, the panel advises.
The decision from the Advisory Committee on Immunization Practices reverses the previous recommendation, which was first made in 1991. From then to 2019, hepatitis B infections in people ages 0-19 decreased by 99%, according to a 2023 public health report from the U.S. surgeon general and the U.S. Public Health Service.
When asked about the advisory council’s recommendation, Dr. Brian Byrd, Tarrant County health director, noted the vaccine’s efficacy.
“While I always support parental rights regarding medical decisions for their children, the evidence shows that the hepatitis B vaccine program, which depends on a birth dose, has been remarkably safe and effective,” Byrd’s statement read.
Prior to the vaccine advisory panel’s ruling, Dr. Philip Huang, director of Dallas County Health and Human Services, also remarked on the vaccine’s decadeslong success at a webinar hosted by the Big Cities Health Coalition.
“The birth dose is really the single most effective tool that we have to prevent lifelong chronic hep (hepatitis B) infection,” he said.
The panel’s recommendation becomes a part of the CDC’s official recommendations after being adopted by the CDC director.
“The American people have benefited from the committee’s well-informed, rigorous discussion about the appropriateness of a vaccination in the first few hours of life,” said CDC acting director Jim O’Neill in a statement after the panel’s recommendation was announced.
Hepatitis B is an incurable infection that causes liver inflammation. The chronic form of the virus can lead to cirrhosis, liver failure and death. The World Health Organization estimates that 1.2 million people each year contract the infection worldwide.
The disease can be passed along from mother to fetus during pregnancy. The CDC recommends all pregnant patients be screened for the infection in order to properly administer a series of vaccines to a newborn.
However, not all pregnant patients get tested. From 2015-2020, about 14.6% of 506,794 pregnancies did not screen for the hepatitis B antibody test, according to a study from the American Journal of Preventative Medicine.
The advisory council also recommended parents work with their physician to have children tested and see if the first dose gave them a certain level of protection against the infection.
The vaccine is generally given in three doses — the first dose 24 hours within birth, a second dose at 1 to 2 months, and the third between 6 to 18 months. This recommendation may mean some children only get one or two doses.
The panel’s review of the vaccine recommendation was prompted by parental concern about the shot and the fact that the immunization schedule in other countries begins a few months after birth for hepatitis B.
Ismael M. Belkoura is the health reporter for the Fort Worth Report. Contact him at ismael.belkoura@fortworthreport.org.
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