A key vaccine advisory committee in the United States has taken a significant step towards overhauling the nation's long-standing policy on infant immunisation against Hepatitis B. The panel voted to recommend ending the practice of administering the first dose to all newborns within 24 hours of birth.
A Historic Shift in Immunisation Policy
The Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) made its recommendation on Friday. The vote, which passed eight to three, marks a potential departure from a policy that has been in place since 1991. The committee, appointed by Health and Human Services Secretary Robert F Kennedy Junior, had delayed the vote by one day.
Under the new proposal, for infants born to mothers who do not have Hepatitis B, parents should consult with their doctor on whether to vaccinate. The committee also voted that the initial dose should not be given earlier than two months of age. While not binding, such guidance from the ACIP is highly influential and is historically followed by medical professionals across the US.
Rationale Behind the Vote
During the meeting, the committee chair, Dr Robert Malone, acknowledged the seriousness of Hepatitis B, stating the virus's threat was 'not up for debate.' However, members expressed concern over vaccinating newborns whose mothers are not infected, citing the child's low risk of infection at that stage and potential, though rare, side effects from the vaccine.
These can include fever and, in very rare instances, muscle weakness or joint pain. The panel also noted a desire for the US to align more closely with allied nations like the UK and France, which typically recommend the vaccine at two months of age.
Potential Impact and Ongoing Debate
The change would represent a major shift. Since 1991, the US has used a three-dose schedule, with the first dose given at birth, followed by shots at one month and six months. Research shows this regimen is up to 90% effective at preventing mother-to-child transmission if the first dose is given within 24 hours.
The committee still strongly recommends that newborns of Hepatitis B-positive mothers receive the vaccine immediately at birth. An estimated 20,000 infants are born to infected mothers annually in the US, though successful vaccination has reduced transmission to only about 10 cases per year.
The meeting was reportedly combative, with experts criticising the committee's approach. An opinion piece published in JAMA just days before warned that restricting the birth dose could lead to hundreds of additional infections annually. The vote also follows controversial comments from former President Donald Trump in September, who suggested, without evidence, waiting until age 12 to administer the vaccine.
Approximately 91.4% of American children have received the full three-dose series by age two. The CDC will now consider the committee's recommendation before issuing any final updated guidance to the nation's healthcare providers.
