Ohio public health leaders raised concerns about a federal advisory panel's vote Friday to scale back the longstanding recommendation that all newborns receive the hepatitis B vaccine at birth.
The officials said the move could reverse decades of progress against a potentially deadly virus.
Dr. Bruce Vanderhoff, director of the Ohio Department of Health, said during a news conference at Cleveland Clinic that the change sends a troubling message about a vaccine that has dramatically reduced dangerous infections in infants.
“Hepatitis B remains a very, very serious condition. It's a serious illness that causes very serious problems in a person's life if they're infected,” Vanderhoff said. “The vaccine that we have is very safe, it's very effective, and it has clearly reduced the ... number of infants who are acquiring hepatitis B in infancy.”
The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) voted to recommend vaccination at birth only for infants whose mothers test positive for hepatitis B. ACIP members argued that infants born to hepatitis‑negative mothers face a low risk of infection, and said that other developed countries with low rates of hepatitis B do not use a universal birth‑dose policy.
If approved by the CDC's acting director, the new recommendation will be that non-infected parents would be told to consult their physicians.
Hepatitis B vaccination at birth has previously been recommended because newborns can develop lifelong, dangerous infection if they’re exposed to the virus early. The birth dose has been proven to sharply reduce these infections, according to The American Academy of Pediatrics.
The immunization provides immediate protection at a time when babies can be unknowingly infected, even when a parent’s hepatitis B status is missed.
Dr. Prakash Ganesh, medical director at the Cuyahoga County Board of Health, said the U.S. adopted the birth-dose schedule for a reason.
“It’s important to look historically as to why we have the ... vaccine schedule the way it is,” he said. “We’ve prevented a generation of people of getting hepatitis B when we used to see a lot more hepatitis B.”
Ganesh, who previously worked in Malawi and in refugee health care, said he witnessed firsthand what communities face when they don’t have access to the vaccine.
“I unfortunately saw a lot of people die from hepatitis B and and other hepatitis,” he said. “Vaccines are one of those tools that we have that can really prevent anybody from even getting infected or getting sick in the first place.”
Some ACIP members argued that screening pregnant women could replace the universal birth-dose policy. But Ganesh said the vaccine has proven safe and routine for infants.
“It's a well-studied vaccine. And in terms of the side effects, I have not seen a whole lot of downstream effects,” he said. “With hepatitis B, it's a not a live vaccine either, so that's why it's okay to give so early in life.”
National medical groups, including the American Academy of Pediatrics and the Infectious Diseases Society of America, strongly opposed the federal committee’s vote, saying it could leave vulnerable infants unprotected, especially in situations where a mother’s infection status is unknown or inaccurate.
If the new guidance is adopted, both Vanderhoff and Ganesh urged Ohio families to ask their medical providers for advice.
“But we would encourage them to consider the benefits of early vaccination in protecting their child from what is a potentially very serious and lifelong condition,” Vanderhoff said.
