CDC committee drops hep B vaccine recommendation for newborns

A key vaccine advisory panel of the Centers for Disease Control and Prevention voted Friday to withdraw a decades-old recommendation that all newborns be vaccinated against hepatitis B; this is the body’s Secretary of Health and Human Services Robert F. Kennedy Jr. It was its most controversial decision since its overhaul in June.

The Advisory Committee on Immunization Practices voted 8-3 to adopt “individual-based decision-making” regarding newborn hep B vaccine dosing for babies born to women who test negative. 99% of babies born in the USA

The move was condemned by doctors and public health officials, including committee members. The CDC has recommended the vaccine since 1991. 99% drop Rates of chronic hepatitis B infections in children and adolescents.

Casting one of several dissenting votes, Dr. “It is a moral obligation to do no harm. By changing that phrase, we are doing harm,” said Cody Meissner.

Dr., who was formerly a psychiatrist at the National Institutes of Health and is non-voting. “This has the potential to cause great harm, and I hope the committee accepts responsibility when it does,” Joseph Hibbeln said.

The committee was scheduled to spend the rest of Friday discussing the childhood and adolescent vaccination program.

The committee’s public agenda included few details, but comments from speakers and some committee members suggested further revisions to the country’s vaccination practices could be made.

Committee vice chairman Dr. Robert Malone said the committee needed to address the “potential cumulative risk” of childhood vaccines, which he described as the “elephant in the room”.

“Cumulative risk over the entire childhood vaccination program [is] It’s a risk we don’t have enough data for,” said Malone, who contributed to early mRNA research but has since conducted a number of studies. False and unfounded claims about flu and COVID-19 vaccines.

While the CDC’s subject matter experts were removed from the meeting’s agenda, the second day of the meeting began with a presentation from Aaron Siri, a prominent anti-vaccine advocate, in which he called on the committee to “end the mandates” and “depoliticize vaccines.”

In X, Sen. Bill Cassidy (R-La.) Criticized Siri’s existence“Siri is a trial lawyer who makes a living suing vaccine manufacturers. She presents as an expert on childhood vaccines. ACIP has been completely discredited. They are not protecting children.”

Changing the decades-old hep B recommendation has been a worthy goal of anti-vaxxers.

A planned vote on the issue at the committee’s September meeting was tabled following fierce disagreement among members. When the argument resumed on Thursday, it devolved into sustained shouting.

“We are trying to evaluate a moving target,” Hibbeln, one of the strongest opponents of the move, said during the meeting.

While the change to the current recommendation would not prevent newborns from getting the vaccine, Medicaid and other public insurance programs would no longer be required to cover the vaccine, making the birth dose unattainable for millions of poor families and harder for others to access.

Unlike most vaccine-preventable diseases, such as whooping cough and chickenpox, hepatitis B is typically asymptomatic and often spreads silently until middle age, when 1 in 4 infected people develop liver cancer or cirrhosis.

D., medical director of the Viral Hepatitis Programs and Asian Health Center at Cooperman Barnabas Medical Center in New Jersey, who lives with the disease. “This is one of the cancers with the highest mortality rate in the United States,” said Su Wang. “The average life expectancy we give people is six months.”

Opponents of the current vaccine guidance, including Kennedy, surgeon general nominee Casey Means and President Trump, characterize the virus as a result of high-risk “adult” behaviors, including sex and IV drug use.

“Hepatitis B is sexually transmitted,” Trump said at a press conference at the White House in September. “There is almost no point in giving hepatitis B to a newborn baby.”

But experts say most people do not contract the disease this way.

Hepatitis B Foundation president Dr. “It is transmitted primarily from mother to child,” Chari Cohen said.

The majority of infected mothers are immigrants, especially Philippines, China and Vietnam – Making birth-dose vaccination an urgent priority for many families in California.

For some administration officials and panel members, the disease’s prevalence in immigrant communities is a point of contention.

One of the panel’s most vocal advocates for change, Dr. “The elephant in the room is immigration; for years we have faced illegal immigration, undocumented people coming from highly endemic countries,” Evelyn Griffin said.

“We have problems that adults should be solving with our resources there, instead of asking babies to solve it for us,” he said.

Griffin and other opponents of the current vaccine plan say vaccinating everyone puts an unfair burden on healthy newborns from nonimmigrant families whose mothers have either screened negative or have few risk factors for the disease.

But experts say the proposed alternative of universal prenatal testing and aggressive risk assessment is unrealistic for the current American healthcare system. Today, less than 85% of mothers are screened; Some experts say there will be a sharp decline in the coming months if health subsidies are eliminated and Medicaid enrollment is cut.

“Our previous risk-based vaccination strategy has failed,” said Katrin Werner Perez of the Association for Research on Aging. “Before the universal vaccine change in 1991, approximately 20,000 infants and children were infected each year in the United States.”

For babies exposed to blood-borne viruses in the womb or during birth, every minute the vaccine is delayed increases the risk of infection. This fact led American public health officials to increase the initial dose from early childhood, when it was given in the 1980s, to the first 24 hours of life, a recommendation the CDC has maintained since 1991.

“[The vaccine] “It has saved thousands, if not millions, of lives in the United States alone,” Cohen said. “There is more safety and effectiveness data on the hepatitis B vaccine than almost anything else we put in our bodies.”

Data shows that those who contract hepatitis as infants are much more likely to develop chronic and ultimately fatal infections than those who contract hepatitis as adults.

Because the virus can survive on surfaces for up to a week, doctors and public health experts emphasize that babies can catch the virus from even seemingly minor exposures. They said caregivers may not know they have the disease and are less likely to be tested, making the delivery dose more urgent.

“Mom is not the only person around the baby,” Wang told the panel on Thursday, saying she likely caught the disease from her grandparents. “There are grandparents, babysitters, and other young children. You’re basically leaving that baby defenseless.”

Data shows that even a small cut made by shared nail clippers poses a risk of infection.

Kennedy and her allies on the panel counter that the vaccine is unnecessary for most babies and that delaying the vaccine would offer parents the opportunity to participate in “shared clinical decision-making” about whether and when to vaccinate.

Yet the panel has so far struggled to come together around an alternative proposal. A planned vote was tabled Thursday because the proposed language remained in flux even as the meeting continued.

“This is the third version of the questions most of ACIP has received within 72 hours,” Hibbeln said.

Hibbeln and Meissner were vocal opponents of the change in birth dose recommendation when it was first discussed in September.

“We will create new doubts in the public’s mind that are not justified,” Meissner said.

Others said the move wouldn’t go far enough.

Panelist Dr. “I don’t even understand where the debate is about vaccinating young children living in a normal environment,” Retsef Levi said in September.

In addition to limiting public coverage of the vaccine, experts also warned that a change to the recommendation could force privately insured parents to navigate complex layers of authorization to access the birth dose.

Many feared the decision would further stigmatize the vaccine at a time when many parents were rejecting it simply because the recommendation was being reviewed.

“States and hospitals are reporting declines in hepatitis B vaccination,” said Kayla Inthabandith of the Center for Advancing Health Equity in Rural and Underserved Communities. “Even some mothers living with hepatitis B are exposing their own babies to the highest risk of infection by refusing the birth dose.”

Experts have warned that shifting the advice from the first day of life to the second month could lead to 1,400 new infections a year.

Dr. “Every child who gets a hepatitis B infection because we changed our policy is one too many,” Judith Shlay said. “I want us to make sure that none of our children get hepatitis B infection.”