Hepatitis B change endangers babies

The federal immunization panel's decision to end the 34-year-old recommendation that newborns be vaccinated against hepatitis B has put babies at unnecessary risk while upending trusted medical guidance — all without any solid, science-based justification.

Worse, it could be the first step toward undermining decades of medical progress, as President Donald Trump and his public health leaders have suggested reassessing the entire childhood vaccine schedule, a move that could adversely impact the health of all children.

The Advisory Committee on Immunization Practices, as the Centers for Disease Control and Prevention panel is known, voted 8-3 last week to remove the recommendation that all newborns receive the hepatitis B vaccine. Instead, birth mothers who test negative for hepatitis B should discuss the vaccine with their doctors, the panel said.

Committee members and those supporting them, like Health and Human Services Secretary Robert F. Kennedy Jr., contend most infants are at low risk, emphasizing that hepatitis B is primarily a sexually transmitted disease. But that's not the full story. Yes, the disease can be transmitted sexually, or through needles by those using injection drugs. Hepatitis B is also extraordinarily infectious and lives on surfaces, so it can be passed on easily through something as simple as a shared nail clipper or a toothbrush.

The danger is real. Prior to the vaccine's development in 1981, as many as 300,000 people nationwide, including 20,000 children, were infected with hepatitis B each year. About 90% of newborns infected at birth and infants infected prior to their first birthday will develop chronic hepatitis B. A quarter of them will die. There is no cure.

The difference the vaccine has made in over four decades, and especially since the universal newborn recommendation was instituted in 1991, is dramatic. About 17,000 chronic hepatitis B infections are reported annually. Among kids and teens up to the age of 19, just 252 chronic hepatitis B cases were reported in 2022. 

The vaccine is considered safe and effective, according to multiple scientific studies and physician associations, including the American Academy of Pediatrics. Those who oppose the vaccine or the recommendation for newborns say the research is insufficient or that future studies could find a problem. But it's been 44 years — and no such problem has been uncovered.

Scientific development thrives on the asking and answering of legitimate, thoughtful questions. But that's not what's happening here. Scare tactics and unreasoned speculation only fuel the chaos and fear now pervading new mothers' decision-making. Pediatricians, physician associations and local public health officials are now constantly combating the misinformation.

This cannot continue. Sen. Bill Cassidy, a liver specialist whose vote helped to confirm Kennedy, knows that better than anyone. It's up to Cassidy and the rest of the Senate health committee to now question Kennedy and his ACIP members, and to hold HHS funding in the balance. The Senate must act quickly to save the nation's badly damaged public health operations.