(Redrafts paragraph 1, adds subheading on new vaccine committee recommendation)
US Vaccine Advisory Panel on Friday
he conveys his longstanding recommendation that all infants receive the hepatitis B vaccine at birth to Secretary of Health Robert F. Kennedy Jr. a major political victory that disease experts warn could overturn decades of public health progress.
Here’s what you need to know about hepatitis B virus (HBV), available vaccines and new recommendations.
Hepatitis B attacks the liver and is the leading cause of liver cancer worldwide. Many infected people have no symptoms and are unaware that they are infected. In most adults who acquire the virus, the infection resolves on its own. But it becomes chronic in more than 90% of infants and up to 50% of young children who become infected.
Decades after infection, patients may develop liver failure and require a liver transplant. Because hepatitis B cannot be cured, transplant patients often have recurrent liver disease.
HOW COMMON ARE HBV INFECTIONS TODAY?
Hepatitis B infection rates in the U.S. have fallen by nearly 90%, from about 9.6 per 100,000 before vaccination expansion to about 1 per 100,000 in 2018.
The World Health Organization estimates that 254 million people worldwide were living with chronic hepatitis B in 2022, with 1.2 million new infections each year.
HOW IS THE VIRUS TRANSMITTED?
Hepatitis B is most often acquired through contact with bodily fluids from an infected person. It can also be transmitted through needlestick injuries, tattoos, and body piercings.
WHY IS THE VACCINE GIVEN TO NEWBORNS?
Before the widespread availability of the vaccine, mother-to-child transmission during childbirth was the most common route of infection. In the US, before vaccines were available, about 85% of newborns became infected when mothers had an active infection, as did about 30% of babies born to mothers with a previous infection in whom the virus was inactive.
Currently, 0.7% to 1.1% of infants born to such mothers develop infection after vaccination at birth, according to the US Centers for Disease Control and Prevention.
A similar decrease in infant hepatitis B infections was also observed elsewhere with blanket vaccination of newborns. According to a 2022 CDC report, 190 of the 194 WHO member countries adopted the practice as of 2020. More than half of these countries provide it to all newborns immediately after birth.
WHAT IS THE NEW HEPATITIS B VACCINE RECOMMENDATION?
The vaccination committee voted to set aside the hepatitis B birth dose for babies whose mothers test positive for the virus or whose hepatitis B status is unknown. If adopted, the CDC would end a 1991 universal recommendation that protected American children from infections.
For infants whose mothers tested negative, the panel now recommends that parents decide when or whether to start the vaccine series in consultation with their health care provider.
In addition, the panel supported the recommendation that parents, in consultation with a health care provider, test children for hepatitis B antibodies before deciding to give further injections.
WHY TREAT ALL BABIES, NOT JUST THOSE WITH INFECTED MOTHERS?
Universal dosing at birth protects infants whose parents have unknown or untested hepatitis B status during prenatal care. Also, maternal testing can miss recent infections, making universal newborn vaccination more reliable.
Even if mothers are not infected, newborns can acquire hepatitis B from close contact with other infected individuals and caregivers.
WHAT IS KNOWN ABOUT ADVERSE REACTIONS?
The hepatitis B vaccine is generally considered safe. Side effects are usually mild, such as soreness at the injection site or low-grade fever, while serious allergic reactions, including anaphylaxis, are extremely rare, according to the WHO.
(Reporter embedding, Roy, Padmanaban Roy,
