Statement from Dr. Michael Warren, Chief Medical and Health Officer, March of Dimes:
Hepatitis B infection is preventable. The strong, science-driven approach to public health in this country over the past few decades has helped to nearly eliminate hepatitis B infection in children, adolescents, and young adults. Today’s actions by the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices jeopardize that progress and threaten infants with an infection (and potential lifelong consequences) that is otherwise preventable. This is a step backwards for us as a nation. March of Dimes supports the recommendation of the American Academy of Pediatrics that all newborns receive the hepatitis B vaccine.
Immunization is one of the most important public health accomplishments of the last century. In particular, childhood immunization against preventable diseases has resulted in substantial decreases in illness, disability, and death across the United States.
One routine childhood immunization is for hepatitis B, a viral infection that can be passed to babies and young children by their caregivers. When hepatitis B vaccine was first introduced on the immunization schedule in the 1980s, the recommendation was to immunize infants born to women with hepatitis B. However, that recommendation was not fully successful in eliminating hepatitis B from being transmitted to children because hepatitis B is not transmitted exclusively during the birth process, and not all people with infection fit a particular risk profile or know that they are infected with hepatitis B. Additionally, while mothers are recommended to be tested for hepatitis B infection during pregnancy, testing may not always happen, or test results can be wrong (“false negatives”). In 1991, immunization guidelines were updated to recommend that every baby receive the first dose of hepatitis B vaccine at birth to ensure every baby is protected from hepatitis B disease. Following the adoption of that guideline, the rates of hepatitis B infection in infants dropped by 99%.
When an infant is infected with hepatitis B at birth, the consequences can be devastating; 90% will go on to develop chronic hepatitis B, and a quarter of those will die prematurely. For young children who acquire Hepatitis after birth, up to 50% will go on to develop chronic hepatitis B. Children and adults with chronic hepatitis B often go on to develop cirrhosis, liver failure, and liver cancer. Newborn vaccination against hepatitis B protects against these consequences. The hepatitis B vaccine given at birth offers protection far beyond the newborn period, as evidenced by lower rates of hepatitis B among adolescents and young adults in the years following the implementation of the universal newborn vaccination recommendation in the 1990s.
The U.S. is among the most dangerous developed nations for childbirth. Each year, over 20,000 infants die before reaching their first birthday. There is still so much work to do to prevent infant deaths, including from birth defects and conditions like prematurity (where we still don’t know all the answers). In the meantime, in the cases where we already know what to do, and we already have the tools to do it, we should be absolutely certain that we are taking every step possible to prevent every death possible. That is the case for vaccinating every infant against preventable illnesses like hepatitis B.
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