ACIP Reverses Advice for Hepatitis B Birth Dose

The Advisory Committee on Immunization Practices (ACIP) – a panel that shapes policy around vaccinations on behalf of the Centers for Disease Control and Prevention (CDC) – voted today to reverse a long-standing recommendation for infants to receive a dose of the hepatitis B vaccine within the first 24 hours after birth.

Instead, the panel agreed to recommend individual-based decision-making for families who are considering giving their infant the hepatitis B shot at birth when the mother has tested negative for the virus. The panel also suggested that for infants who don’t receive the birth dose, healthcare providers delay administering an initial dose until at least the two-month mark.

While ACIP’s recommendations are not final until approved by the CDC’s current director, the agency typically uses the committee’s decision in creating it’s broader vaccination guidance which helps frame what physicians recommend to patients along with states’ vaccine policy and insurance coverage.

Reversing the Guidelines: why the Change?

During the voting session, panel members in support of the recommendation change offered questions about the safety of giving the hepatitis B vaccine to all newborns, citing concerns about health risks potentially linked to the vaccine, such as a theoretical increased risk of autoimmune diseases.

Experts at major medical organizations have said that any evidence behind these risk claims is limited and outweighed by strong evidence that the so-called birth dose plays a crucial role in preventing a serious infection that can lead to liver disease and early death.

Decades of surveillance data and research – including a recent independent evidence review – have supported the safety, efficacy, and public health impact of the global hepatitis B vaccine recommendation at birth.

Landmark randomized placebo-controlled clinical trials have demonstrated the vaccine’s long-term protection against illness from an acute (short-lived) or chronic (long-lasting) hepatitis B infection.

“Let me be very clear about this: Delaying the birth dose would leave newborns unprotected during a critical window in their lives,” said Jose R. Romero, MD, a member of the American Academy of Pediatrics Committee on Infectious Diseases and a former ACIP chair, in a press briefing on Thursday. “Children will die preventable deaths without timely access to the hepatitis B vaccine. The hepatitis B vaccine is one of the most important tools we have for protecting newborns in the first 24 hours of life.”

What Is Hepatitis B and Why Are Newborns at Risk?

Hepatitis B is a viral infection that attacks the liver.