CDC Advisers Vote to End Universal Hepatitis B Shot for Newborns

A federal vaccine advisory committee voted on Friday to end the recommendation that all U.S. newborns receive a hepatitis B vaccine at birth, a policy in place since 1991. CBS News reported that the Advisory Committee on Immunization Practices, known as ACIP, voted 8-3 to have parents and providers decide “when or if” to give the birth dose to babies whose mothers tested negative for the virus. A separate 6-4 vote, with one abstention, called for parents to consult doctors about testing whether the first dose produced protection.

The Associated Press reported that the birth dose remains recommended for babies whose mothers test positive or were not tested. If a family declines it, the series should start at 2 months. The recommendation goes next to acting CDC Director Jim O’Neill, who is expected to decide whether to accept it; the agency currently has no director, the AP said. States set their own policies and can diverge from federal guidance, and most private insurers must cover ACIP-recommended vaccines, so coverage could change if the recommendation does, CBS reported.

Members who backed the change said the infection risk for most babies is very low, that earlier safety research on infants was inadequate and that doctors often do not fully discuss pros and cons with parents, according to the AP. Two members said they saw no documented evidence of harm from birth doses. Committee member Vicky Pebsworth cited “pressure from stakeholder groups wanting the policy to be revisited.”

Opposition came from inside and outside the room. Dr. Cody Meissner, who voted no, said, “We are doing harm by changing this wording,” CBS reported. Dr. Joseph Hibbeln said the language presented was the fourth version in 96 hours and that “no rational science has been presented” to support the change; the AP quoted him calling the proposal “unconscionable” and saying no data supported two months as the cutoff. Dr. William Schaffner of Vanderbilt University, an infectious disease specialist, told the AP, “This is the group that can’t shoot straight.” The American Academy of Pediatrics and other experts also opposed the change, CBS said.

Sen. Bill Cassidy, a Louisiana Republican and physician who chairs the Senate health committee, called the change “a mistake” and urged O’Neill to reject it. Cassidy said that before the birth dose was recommended, “20,000 newborns a year were infected with hepatitis B,” and that the number is now fewer than 20, according to CBS. That figure is Cassidy’s statement; the report did not cite a CDC count.

The stakes, as CBS described them: hepatitis B is incurable, and infants infected at birth or in their first year have about a 90 percent chance of chronic infection, which can lead to cirrhosis, liver failure or liver cancer. Infections among infants and children have fallen about 99 percent since the universal birth dose began. About 16 percent of expecting mothers are missed by prenatal screening, according to the CDC.

All current ACIP members were appointed by Health Secretary Robert F. Kennedy Jr., who fired the previous 17-member panel, the AP reported, and recent meetings no longer feature CDC scientists presenting safety and effectiveness data. Kennedy was a leading anti-vaccine activist before taking office. President Donald Trump praised the vote and signed a memorandum directing HHS to review vaccine schedules in other developed countries, CBS reported; the AAP says those schedules are largely similar.