Hepatitis B Vaccine Recommendations Under Review Amid Controversy

The Advisory Committee on Immunization Practices, or ACIP, voted to stop recommending universal hepatitis B vaccinations for newborns, a significant change from a 34-year prevention strategy that has greatly reduced early childhood hepatitis B infections in the United States.

Before the U.S. implemented routine vaccination in 1991, approximately 18,000 children contracted the virus annually before age 10, with half of those infections occurring at birth. Presently, fewer than 1,000 children or adolescents contract hepatitis B each year, marking a 95% decrease, with fewer than 20 babies reported infected at birth.

The ACIP's new recommendation allows the hepatitis B vaccine only for infants born to mothers who test positive for the virus, while advising consultation for those born to negative mothers, introducing uncertainty into previous clear guidance.

Pediatrician David Higgins notes this change can mislead parents regarding the risks of hepatitis B, which can still infect children through household exposures. He emphasizes the importance of the vaccine, stating that vaccinating at birth protects against infections that could lead to chronic conditions, liver damage, and premature death.

The committee's decision has raised concerns among health experts who warn about the potential for increased infections, with research estimating an additional 476 perinatal hepatitis B infections annually if the vaccine is not given universally.

The hepatitis B vaccine has an excellent safety record, with the only notable risk being a rare allergic reaction in one in 600,000 doses. The change in recommendation could undermine decades of progress in preventing hepatitis B infections in the U.S.