Experts Advocate for Universal Hepatitis B Vaccination at Birth

Leading experts are calling for the continuation of a universal hepatitis B vaccination policy for newborns in the United States. In a recent commentary published in Gastroenterology, they emphasize the importance of administering the first dose of the hepatitis B vaccine within 24 hours of birth. With over one billion doses administered globally, hepatitis B vaccines have proven to be both safe and effective.

The Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) have long recommended hepatitis B vaccination for all infants. This includes not only those born to mothers who test positive for the virus but also those with unknown maternal status. Their guidelines have evolved, with the most recent update in 2018 recommending vaccination for all infants within 24 hours of birth, including preterm infants.

The authors of the commentary highlight the universal “birth dose” as a crucial measure in preventing chronic hepatitis B infection. This infection can lead to severe health complications, including cirrhosis and liver cancer. The implementation of these vaccination policies has resulted in a remarkable 95% decline in infant hepatitis B infections, preventing an estimated 90,000 deaths and one million hospitalizations.

Why Universal Vaccination Matters

Dr. Anna S. Lok, M.D., the first author and an expert in hepatology at Michigan Medicine, explains that knowing the hepatitis B status of every mother is a challenge. “The U.S. health care system is not perfect,” she notes. Many individuals lack insurance, and some may arrive at hospitals late in labor, making it difficult to assess maternal health before delivery. By vaccinating all newborns, the risk associated with unknown maternal status is effectively mitigated.

Moreover, hepatitis B can be transmitted beyond maternal lines. Dr. Lok points out that fathers, grandparents, or caregivers can also pose a risk. “While the primary source of infection is the mother, babies can get infected from other family members or caregivers,” she states. This highlights the need for a comprehensive vaccination strategy.

The stakes are high; if a newborn contracts hepatitis B, there is a 90% chance they will develop a chronic infection, leading to serious health consequences later in life. In contrast, the risk of chronic infection drops to 5% if individuals are infected as adults.

Safe Vaccination Practices

Concerns regarding the safety of the hepatitis B vaccine have been addressed through decades of research. Approved in 1981, the vaccine has been administered over one billion times, making it one of the few vaccines deemed safe for use in newborns and pregnant women. Dr. Lok emphasizes, “There are very few things we feel comfortable recommending for use during pregnancy or for newborns within the first 12–24 hours of birth.”

The message for parents and policymakers is clear: the hepatitis B vaccine is not only safe and effective but also a cost-effective preventive measure. “If we give the vaccine to every newborn baby at the time of birth, we can prevent infections,” Dr. Lok asserts. Waiting for individuals to contract the virus and then monitoring and treating them is not only more complex but also less effective in the long run.

With credible data supporting the efficacy of hepatitis B vaccination, the experts urge continued adherence to these guidelines. The vaccination not only protects individual health but also serves as a public health strategy to reduce the incidence of chronic hepatitis B infections and their associated complications.

As the conversation around vaccination continues, the focus remains on ensuring that every newborn receives the protection they need right from the start.