Understanding the hepatitis B vaccination and the reasons behind Trump officials' focus on it

NEW YORK This week, a federal vaccine advisory committee is set to review whether newborns should continue receiving the hepatitis B vaccine, historically the first vaccine known to prevent cancer. Current federal guidelines recommend that all infants be vaccinated against the liver infection within the first 24 hours of life. However, the committee led by U.S. Health Secretary Robert F. Kennedy Jr. is expected to propose changes, challenging established public health guidance.

The exact nature of the proposed changes is unclear, but the American Academy of Pediatrics continues to advocate for the birth dose. Dr. Sean O'Leary emphasized, We are going to continue to recommend it because it saves lives. Below is an overview of the disease, the vaccine, and the ongoing debate about altering recommendations.

Hepatitis B and Its Health Consequences

Hepatitis B is a liver infection that typically resolves in under six months for most people. However, infants and children are at high risk of developing chronic infections, which can lead to liver failure, cirrhosis, or liver cancer. In adults, transmission occurs through sexual contact or sharing needles, while infants can acquire the virus from infected mothers. Up to 90% of infants infected with hepatitis B develop long-term infections. The Centers for Disease Control and Prevention estimates 2.4 million people in the U.S. carry hepatitis B, with half unaware of their status.

Historical Development of the Vaccine

Dr. Baruch Blumberg identified the hepatitis B virus in 1965 and later received a Nobel Prize for his discovery, paving the way for tests and vaccines. The first vaccine was licensed in the U.S. in 1981.

Guidelines for Newborn Vaccination

The Advisory Committee on Immunization Practices (ACIP), a federal panel that shapes national vaccine policy, has recommended a birth dose of the hepatitis B vaccine since 1991. Current guidelines advise vaccination within 24 hours for medically stable infants weighing at least 2 kilograms (4.4 pounds), followed by doses at 1 and 6 months.

Earlier practices relied on screening pregnant women to identify babies at risk, but many cases were missed due to incomplete testing or errors. Additionally, the virus can survive on surfaces for over a week, increasing the risk of transmission in households with infected individuals. Over three decades, the birth dose program has reduced pediatric hepatitis B cases from roughly 18,000 annually to 2,200. Analysis from the Vaccine Integrity Project confirms the vaccines safety and its central role in preventing infections.

Committee Reconsiders Newborn Recommendations

After removing all previous ACIP members, Secretary Kennedy appointed a new panel, including voices critical of early vaccination. The committee has questioned whether infants should be given a vaccine primarily meant to address adult infections. Dr. Evelyn Griffin asked at a September meeting, Are we asking our babies to solve an adult problem? Dr. Robert Malone added concerns about parental trust and consent for newborn vaccination. While a vote was postponed in September, the matter is scheduled for discussion Thursday. Federal officials have not specified what delay, if any, they might recommend.

Potential Impacts of Delaying Vaccination

Experts have estimated that postponing the first dose until two months of age could result in at least 1,400 new hepatitis B infections and 480 deaths among children. The impact would rise if vaccination were delayed further. Despite ACIPs authority, any change may have limited economic effect since hepatitis B shots are often included in hospital birth costs and government programs like Vaccines for Children.

Medical professionals warn that altering the recommendation could alarm parents and spread misinformation online. Public health groups, state officials, and coalitions of Northeastern leaders have pledged to maintain the birth dose. Senator Patty Murray of Washington criticized the potential policy shift, calling it a heartless choice to allow babies to die.

Author: Grace Ellison