CDC Vaccine Committee rescinds decades-old hepatitis B recommendations for newborns

Members of a key CDC advisory committee, known as the Advisory Committee on Immunization Practices, met on December 4 in Atlanta. Maya Homan/Georgia Recorder

ATLANTA — A committee of the Centers for Disease Control and Prevention has voted to eliminate the recommendation that all newborns be vaccinated against hepatitis B, ending a policy in place since 1991 to protect Americans against hepatitis B. incurable liver disease which can lead to cirrhosis, cancer and liver failure.

Current a series of three doses against hepatitis B consists of one vaccine given to infants within 24 hours of birth, followed by further booster doses given one month and six months after the initial dose. A universal vaccination policy is this assigned with a 99% decline in earnest infections among American children from 1990 to 2019.

In its updated guidance, the agency will continue to recommend vaccination at birth for babies born to mothers who have tested positive for hepatitis B. However, in all other cases, the decision will be left to “individual decision-making,” which is a change experts say will lead to escalate in chronic hepatitis B infections. The modern recommendation also suggests that parents delay the first dose of vaccine for at least two months after birth.

Friday’s decision came after an 8-3 vote from a key CDC advisory committee, known as Advisory Committee on Immunization Practiceswhose role is to set national guidelines for how people should be vaccinated against a wide range of preventable diseases and when these vaccines should be administered. The recommendations play a key role in determining which insurance companies are willing to cover the costs of vaccines and how accessible these vaccinations are to the public.

The two-day meeting included several presentations from prominent anti-vaccination activists, including Aaron Siri, a vaccine injury lawyer who previously represented U.S. Secretary of Health Robert F. Kennedy Jr. and apparently helped him vet health officials in President Donald Trump’s administration. At least two of them – Cynthia NevisonAND climate researcher who has ties to anti-vaccination groups and Mark BlaxilAND former consultant and the author—were recently hired by the CDC.

Retsef Levi, ACIP member and professor in operations management at the Massachusetts Institute of Technology called the updated recommendation “a very positive policy change,” arguing that blanket vaccine recommendations force newborns to serve as a “safety net against adult errors.”

However, Dr. Cody Meissner, another committee member who also serves: professor in pediatrics and medicine at Dartmouth College, argued that vaccines play a key role in protecting infants from the disease, and said there was no valid scientific evidence to support the panel’s changes.

“A thoughtful investigation is always commendable,” he told the committee. “However, this inquiry should not be confused with unfounded skepticism, which is what I believe we are dealing with here.”

Sandra Fryhofer, a physician and liaison for the American Medical Association, also criticized the move, arguing that implementing guidelines based on the mother’s liver health would put babies at risk of developing the disease from other sources, such as infected relatives. According to CDC dataAbout half of people with hepatitis B do not know they are infected.

“Will we test every patient who has access to or touches the baby?” – she asked the committee on Thursday. “I mean, it’s not something that’s really doable.”

The updated hepatitis B vaccine recommendation reflects the Covid-19 vaccine guidance adopted by the same panel in Septemberthat put modern emphasis on the risks of vaccinations, via the CDC own data shows that vaccines are sheltered and effective for most people.

The second vote, which passed 6-4, encourages parents to discuss employ serological testsa type of blood test that measures antibodies to assess how well the patient’s immune system has responded to the disease before allowing the child to receive additional doses of the hepatitis B vaccine.

The revised recommendations won’t prevent doctors from giving newborns hepatitis B vaccines, but critics say they could create additional hurdles for families and health care providers.

“Adding excessive or ambiguous language to shared decision-making about routine vaccines confuses the situation, creates a false sense of scientific uncertainty, and places unnecessary burdens on physicians and families,” Dr. said. Natasha Bagdasarianwho represented the Association of State and Territorial Health Service Officials.

Children enrolled in Medicaid or Vaccines for Children Programthat provides free vaccinations to uninsured and underinsured children will still be eligible for hepatitis B vaccinations at birth under modern recommendations, program liaisons say.

Federal fallout

As with the modern Covid-19 vaccine recommendations, the updated hepatitis B guidelines will not go into effect until officially signed by acting CDC Director Jim O’Neill.

But in the midst changes in federal guidelines in public health policy, an increasing number of state and federal officials are developing them own rules rather than relying on agency guidelines. On December 3 letter sent before the ACIP meeting, more than 30 members of Congress urged O’Neill to uphold existing recommendations regardless of the advisory committee’s decision.

“There is no data to support delaying the first vaccination for up to one month, four years or 12 years,” the letter reads.

U.S. Sen. Bill Cassidy, a Louisiana Republican who chairs the Senate Health, Education, Labor and Pensions Committee, also called on O’Neill to refrain from signing updated recommendations.

“As a liver disease physician who has treated hepatitis B patients for decades, this change in the vaccination schedule is a mistake,” he wrote in a social media post after the vote. “The hepatitis B vaccine is safe and effective. The birth dose is a recommendation, not a mandate.”

Cassidy, a physician, cast the deciding vote to confirm Kennedy as health secretary under the condition that Kennedy “keeps the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices unchanged.” Kennedy he later withdrew making good on that promise by firing all 17 previous committee members and replacing them with a hand-picked list of people, many of whom are perceived to be skeptical of vaccines.

In a social media post on Thursday, Cassidy said criticized committee on plans to hear testimony from Siri, a vaccine-injury lawyer.

“ACIP is completely discredited,” he added. “They don’t protect children.”