CDC Committee Is Set for a Big Vote on Hepatitis B Vaccines

A federal panel is preparing to reconsider the long-standing recommendation that all US newborns receive the hepatitis B vaccine, a move likely to spark fresh debate over childhood immunization policy. The CDC's Advisory Committee on Immunization Practices (ACIP) is expected to discuss later this week whether to restrict the shots to infants whose mothers are known to be infected with hepatitis B, or to delay the first dose until later in childhood. It's anticipated that the panel will vote to delay that first dose until age 4, reports NPR. "Age 4 makes zero sense," pediatrician Eric Ball pushes back. "We recommend a universal approach to prevent those cases where a test might be incorrect or a mother might have unknowingly contracted hepatitis."

• The hepatitis B vaccine has dramatically reduced cases of maternal transmission in the US, with infections among newborns dropping from about 20,000 annually before the 1990s to fewer than 20 today, per the New York Times.
• Still, some ACIP members, echoing concerns from Health Secretary Robert F. Kennedy Jr. and others, have questioned whether universal newborn vaccination is necessary. Kennedy and his supporters argue that the virus is primarily spread through sexual contact and shared needles, making routine vaccination for all infants excessive.

• Health experts, however, say the virus can also be transmitted via everyday items like toothbrushes, washcloths, and combs and point out not all mothers are reliably screened for hepatitis B before birth. Major medical bodies have warned that such a risk-based approach to vaccination could lead to missed cases.
• Globally, most countries immunize infants against hepatitis B soon after birth, though a few, such as Britain and Denmark, vaccinate at birth only if the mother is infected. The CDC's vaccine experts, normally central to preparing for such meetings, have been kept at arm's length this time, highlighting the contentious nature of the discussion.
• State officials, including those in Massachusetts, say they'll develop their own updated guidelines if federal policy shifts away from science-based recommendations.
• The Independent notes that when ACIP meets on Thursday and Friday, the panel is expected to vote on its recommendations for COVID and chickenpox vaccines as well. A vote is also possible that would restrict a government program from paying for vaccines for low-income families. "I'm tightening my seatbelt," warns Vanderbilt University vaccine expert Dr. William Schaffner.