Panel appointed by RFK Jr. removes recommendations for universal hepatitis B vaccine for US infants

A panel of advisers to the U.S. Centers for Disease Control and Prevention (CDC) has voted to remove a long-standing recommendation to universally vaccinate American infants against hepatitis B.

For infants of mothers who test negative, the panel recommended that parents should consult with a health care provider to decide when or whether their child will begin the vaccine series. Under the eliminated recommendation, two more vaccines are given at birth at one to two months of age and at six to 18 months of age.

The vote does not change guidance for infants born to mothers who are positive for hepatitis B — they should still be vaccinated at birth, according to recommendations.

Since 1991, universal hepatitis B vaccine has been recommended in the US, including giving one dose shortly after birth. Studies have shown that the vaccine reduces infection rates by up to 95 percent.

The committee also voted in favor of antibody testing after children receive the hepatitis B vaccine to determine whether further doses are needed.

CDC’s Advisory Committee on Immunization Practices (ACIP) makes recommendations on the use of vaccines for Americans to the CDC Director who then sets policy.

Although their new guidance recommends how doctors should administer the hepatitis B vaccine, doctors can still give babies the vaccine at birth if parents want to get their children vaccinated right away.

Public health experts condemned the move, saying the change to the shared clinical decision-making process would create barriers to access to vaccines and that parents already have control over their children’s care.

The vote, originally scheduled for Thursday, was postponed amid the turmoil of the opening day of presentations. At times, the conversation became tense as some members, experts and citizens raised questions about the safety of hepatitis B vaccination and the risks of infection raised by members on the panel, who were criticized and described as misleading.

Su Wang, a doctor and senior advisor at the Hepatitis B Foundation, described how she contracted the virus as a child from one of her caregivers, many of whom were hep B positive. He said a policy that assessed risk based only on his mother’s condition might not have prevented him from getting infected with the virus, but universal vaccination – which was not in place at the time of his birth – could.

“We can’t predict a child’s future risk. Like seatbelts, our overall risk of being involved in a (car) accident is low, but we universally wear them because we can’t control the world around us,” Wang said.

Universal vaccination better than just testing: Experts

But committee members supporting the change said universal vaccination is not necessary in “low-risk” cases, where babies are born to mothers who have tested negative for hepatitis B.

Experts say it may cause harm to some mothers and babies and is not enough to combat hepatitis B on a large scale.

“The policy has always been to test every pregnant woman against hepatitis B, but that doesn’t happen,” said Amesh Adalja, an infectious disease physician and a senior scholar at the Johns Hopkins Center for Health Security.

She says inadequate prenatal care means some women don’t get tested before giving birth. Hepatitis B infection that occurs after a negative test but before the baby is born, or due to a false negative test, may cause some babies to get hepatitis B even if their mothers have been tested.

Hepatitis B is a bloodborne disease, and is often associated with the potential to spread through sexual contact or the use of shared needles. But it can also be spread from caregiver to baby in early life through contact with something like a cut, according to Eric Yoshida, a liver specialist at Vancouver General Hospital and professor at the University of British Columbia’s medical school.

Yoshida says it’s also more likely that people who don’t get vaccinated right away won’t be fully vaccinated against hepatitis B — which could lead to liver cancer, cirrhosis or failure later in life.

According to both Adalja and Yoshida, there is no evidence to show that any significant risk is associated with hepatitis B vaccination.

CDC recommends hepatitis B vaccination at birth for infants in the US since 1991 As an effective way to prevent infection. This has been the policy in Canada for decades and continues to be the same policy even now – The The National Advisory Committee on Immunization (NACI) has recommended Infants receive the first dose of hepatitis B vaccine in the first month of life, the second dose at least four weeks later, and the third dose at least two months after that.

World Health Organization also recommends Children should receive the first dose of hepatitis B vaccination as soon as possible after birth, ideally within the first 24 hours of life.

The CDC is a US organization, so its recommendations do not directly affect Canada. But given how contagious the virus is, Adalja says, “The more people on this planet who have hepatitis B, the greater the risk to everyone else if they don’t get vaccinated.”

Also, skepticism about vaccines is not isolated to the US – this is evidenced by the increasing spread of measles, which experts have linked to decreased uptake of vaccines and distrust of vaccine, which caused Canada to lose its abolition status for that disease earlier this year.

“It’s not that the virus is contagious. The anti-vaccine movement is contagious,” Adalja said. “So this may be a debate you’ll be having in Canada as well.”

Previous vote changed guidance on COVID-19, MMRV shots

The vote on the hep B vaccine program was initially scheduled to take place in September, but was rescheduled for Thursday due to requests for more data — and then postponed until today to give committee members more time to consider the language of the vote.

At their September meeting, The panel changed some of its guidance About COVID-19 vaccination and the childhood measles, mumps, rubella and varicella (MMRV) vaccination programme. Rather than directly recommending a COVID-19 vaccine for most adults, the panel said they advised people to decide whether to get vaccinated with their doctor.

He also voted against allowing parents to choose the combined MMRV vaccine for children under four, and instead recommended separate vaccines – one for MMR, and a separate one for varicella (commonly known as chickenpox).

Members of the panel, which was hand-selected by Health and Human Services Secretary Robert F. Kennedy Jr., have been criticized for their skeptical comments about vaccines or the spread of infectious diseases.

Kennedy – who has promoted fragmented theories of linking autism vaccines And raised questions on the safety of the vaccine- heyAll previous 17 members of the advisory panel were used In June, before refilling it with new appointments.

ACIP vice president Robert Malone, who chaired two days of meetings, later raised questions about vaccines during the COVID-19 pandemic. First overstated its role in early research on mRNA vaccines — The technology behind most Covid shots.

Retzef Levy, another RFK appointee to the panel, has questioned the safety of COVID-19 vaccines and previously called for them on social media. All Covid vaccine programs will be stoppedHe is a professor of operations management and does not have a medical degree,

As a result, Adalja says, the panel and the CDC itself have lost their credibility and are becoming “increasingly irrelevant.” groups like American Academy of Pediatrics He points out that the American College of Physicians has also begun issuing its own guidance in lieu of reliable CDC recommendations.

“(CDC and ACIP) are no longer reliable sources of information for the general public,” Adalja said.

At the beginning of Friday’s meeting, Malone defended the panel, saying he and other members were not anti-vaccine but were reevaluating the safety of the vaccines as public trust in vaccines among Americans has declined since the COVID-19 pandemic.

Malone said, “We must boldly address the change, risk, new ideas, and conflicting hypotheses that are the proper nature of evidence-based science.” “I urge that we can all commit to openly considering alternative viewpoints.”