On Tuesday, the U.S. Centers for Disease Control and Prevention ended a long-standing recommendation that all U.S. newborns receive the hepatitis B vaccine, instead leaving it up to parents, in consultation with a health care professional, to decide whether infants born to hepatitis B-negative mothers should receive the vaccine, including the dose at birth.
The agency’s decision follows a recommendation from Health Secretary Robert F. Kennedy Jr.’s vaccine advisory committee, which involves a major change in health policy. Earlier this month, the committee recommended that the birth dose be given only to newborns whose mothers are hepatitis B positive or whose status is unknown, which the CDC approved as policy Tuesday.
If parents choose not to vaccinate their newborn at birth but believe vaccination is warranted, the agency now recommends waiting at least two months before giving the child’s first dose of the vaccine.
Since 1991, U.S. health officials have recommended universal vaccination of infants against hepatitis B, with the first of three shots given very soon after birth.
The agency’s recommendations impact health insurance coverage in the United States and play a critical role in helping doctors choose the appropriate vaccines for their patients.
Experts warn that the new recommendation, which the CDC describes as an individual decision, could expose more children to the dangerous virus and cause more families to forgo vaccination in the absence of strong federal policy. Kennedy is a longtime anti-vaccine activist who has made sweeping changes to U.S. vaccination policy.
Dr. Emily Landon, an infectious disease expert at the University of Chicago Medicine, said the role of the CDC advisory committee is to help clinicians interpret the wealth of scientific data and make the right decisions about the care of their patients.
“This recommendation ignores scientific data. The fact that the Acting Director of the CDC has endorsed this recommendation only reinforces the idea that they are no longer committed to making science-based recommendations to improve health,” Ms. Landon said.
Hepatitis B can cause serious liver disease and is spread primarily through blood, semen or certain other body fluids, but also through close contact with people who are unaware they are infected, such as caregivers or friends.
Hepatitis B infections have declined by nearly 90% in the United States, from 9.6 per 100,000 people before widespread vaccination to about 1 per 100,000 in 2018.
The agency said it is reviewing the committee’s secondary recommendation that parents consult a healthcare professional about antibody testing to determine if an additional dose of hepatitis B vaccine is needed.
