A recent recommendation by the Advisory Committee on Immunization Practices (ACIP) to move away from universal hepatitis B vaccination for newborns has prompted discussion among health experts. Anand Parekh, chief health policy officer at the University of Michigan School of Public Health, commented on the change and its potential impact.
The policy of universal hepatitis B vaccination for infants was introduced in 1991. According to Parekh, this approach led to a significant reduction—99 percent—in cases among infants and children, helping prevent chronic illness, liver disease, and liver cancer.
“For several decades, the ACIP has recommended universal hepatitis B vaccination within 24 hours of birth, followed by completion of the vaccine series to prevent infant infection which can lead to chronic hepatitis B and liver disease. The birth dose prevents perinatal transmission due to a lack of testing or failures in reporting test results. It also provides protection to infants at risk from household exposure after the perinatal period,” said Parekh.
He noted that the new recommendation comes from an ACIP panel with many members lacking backgrounds in infectious diseases and immunization. The updated guidance encourages parents whose babies are born to women who test negative for hepatitis B to make individual decisions about vaccination rather than following a universal protocol.
“History has taught us that a universal vaccination strategy has been associated with dramatically reduced cases of chronic hepatitis B infections among young people. The recent ACIP recommendation did not include any new data uncovering risks of the vaccine and seemingly ignored the overwhelming amount of scientific evidence in favor of universal vaccination,” he added.
Parekh expressed concern that changing long-standing recommendations without new supporting evidence could create confusion among families and increase skepticism toward vaccines. “ACIP’s recommendation will undoubtedly create confusion amongst the public. It will also substantially increase the need for patient education about the importance of the hepatitis B vaccine series to prevent infection and chronic liver disease in children.”
He also addressed how these changes may affect healthcare providers: “Changes to recommendations that are not based on new scientific evidence and data place clinicians and public health officials in a difficult situation when speaking to patients and the public, respectively. The tragic irony is that while current health policy leaders have the goal of reversing the children’s chronic disease epidemic, this recommendation would increase the risk for chronic liver disease in children.”
Regarding ACIP’s suggestion that parents request antibody testing after initial vaccination doses, Parekh stated: “ACIP’s recommendation that parents request clinicians obtain blood antibody levels after the first vaccine dose to determine whether additional shots are needed is concerning. It shifts responsibility to parents and may lead to missing the vaccine or not being fully protected. This recommendation is also not supported by evidence. Rather, data continues to demonstrate that the full three-dose vaccination series produces robust, long-term protection from hepatitis B infection.”
Parekh concluded by advising individuals with questions about hepatitis B vaccines to consult their personal clinicians: “While one would hope that the CDC will reject the ACIP’s recommendation, this is unlikely to occur. The bottom line is that individuals should turn to their personal clinician if they have any questions about the hepatitis B vaccine.”
