US CDC ends guidance that all newborns should get hepatitis B vaccine, in major policy shift

The Advisory Committee on Immunisation Practices (ACIP) votes on the recommendation of the childhood hepatitis B vaccine (Reuters photo)

The US Centers for Disease Control and Prevention on Tuesday ended a long-standing recommendation that all US newborns receive the hepatitis B vaccine, leaving it instead to parents, in consultation with a healthcare provider, to decide whether infants born to hepatitis B-negative mothers should get the vaccine, including the birth dose.

The agency’s move follows a recommendation from Health Secretary Robert F. Kennedy Jr.’s vaccine advisory panel that entails a major change in healthcare policy. Earlier this month, the panel recommended that a birth dose should only be given to newborns whose mothers test positive for hepatitis B or whose status is unknown, which the CDC approved as policy on Tuesday.

If parents choose not to vaccinate their newborn at birth but feel vaccination is warranted, the agency now recommends that they wait at least two months before giving the child a first dose of the vaccine.

Since 1991, US health officials have recommended universal vaccination for infants against hepatitis B, with the first of three shots administered very soon after birth.

The agency’s recommendations affect US health insurance coverage and play a key role in assisting physicians in choosing appropriate vaccines for patients.

Experts warn the new recommendation, which the CDC described as individual-based decision-making, could expose more children to the harmful virus and could lead to more families opting out of vaccination in the absence of a firm federal policy in place. Kennedy is a longtime anti-vaccine activist who has made far-reaching changes to US vaccination policy.

Dr. Emily Landon, an infectious diseases expert at the University of Chicago Medicine, said the CDC’s advisory panel’s job is to help clinicians interpret piles of science and help them make good decisions on how to care for their patients.

“This recommendation is ignoring the science. The fact that the acting director of the CDC would sign on to this just continues to reinforce that they are no longer committed to science-based recommendations for improving health,” Landon said.

Hepatitis B can lead to serious liver disease and is primarily spread through blood, semen, or certain other body fluids. It can also be spread by close contact with people who do not know they are infected, such as caregivers or friends.

Hepatitis B infections have fallen nearly 90 per cent in the US, from 9.6 per 100,000 individuals before vaccination became widespread to about one per 100,000 in 2018.

The agency said it is reviewing the committee’s secondary recommendation that parents should consult with a healthcare provider on antibody testing to determine whether a subsequent hepatitis B vaccine dose is needed. (Reuters)