U.S. Considers Reversal of Universal Newborn Hepatitis B Vaccine Amidst 99% Drop in Pediatric Cases

The U.S. Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) is reportedly reviewing the long-standing recommendation for universal hepatitis B vaccination of newborns, a policy credited with a 99% reduction in cases among children and teens. This comes amidst concerns from public health experts and organizations who warn against abandoning a strategy proven highly effective in preventing a potentially life-threatening disease.

The debate gained prominence following recent changes within the ACIP, led by Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. Dr. Martin Kulldorff, the newly appointed ACIP chair, has openly questioned the universal birth dose, stating, "Is it wise to administer the hepatitis B vaccine to newborns before they leave the hospital?" This sentiment has sparked alarm among advocates.

Public health organization STAT, citing the historical impact, highlighted the vaccine's success, stating in a recent tweet, > "Dropping hepatitis B shots for newborns would ignore history and endanger children. Cases in kids and teens dropped 99% after the CDC recommended universal vaccination at birth." This dramatic decline underscores the vaccine's effectiveness since its universal recommendation in 1991.

The Hepatitis B Foundation expressed "grave concern" over efforts to revisit the recommendation, noting that the universal birth dose was adopted after targeted risk-based strategies failed to control the spread of the virus, which led to approximately 20,000 infant and child infections annually before 1991. They emphasize that hepatitis B acquired in infancy carries an 80-90% risk of progressing to chronic infection, potentially leading to liver cirrhosis and liver cancer later in life.

Experts argue that the universal birth dose serves as a critical safety net, protecting newborns from unknown maternal infections and mitigating risks from incomplete or delayed prenatal screening. Dr. John W. Ward, Director of the Coalition for Global Hepatitis Elimination, urged ACIP to "continue ACIP recommendations for universal hepatitis B vaccination of newborns," emphasizing that the vaccine is "safe, effective, and lifesaving." Critics of the review process warn that any reversal could lead to increased preventable infections and undermine public trust in established immunization policies.