Experts Advocate for Universal Hepatitis B Vaccination at Birth

Leading health experts are calling for the continued administration of the hepatitis B vaccine to all newborns in the United States within 24 hours of birth. A commentary published in the journal Gastroenterology emphasizes the importance of this universal vaccination practice, which has contributed significantly to reducing infant hepatitis B infections.

Since the initial recommendations made by the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) in 1991, the hepatitis B vaccine has been recognized as safe and effective, with over one billion doses administered globally. The guidelines were updated in 2005 to mandate that infants born to mothers with hepatitis B receive their first dose within 12 hours of birth. In 2018, the advice was expanded to include all infants, emphasizing that the first dose should be given within 24 hours of birth.

This universal “birth dose” is viewed as a critical measure for preventing chronic hepatitis B infections, which can lead to severe health issues such as cirrhosis and liver cancer. The implementation of these policies has resulted in a staggering 95% decline in hepatitis B infections among infants, preventing an estimated 90,000 deaths and one million hospitalizations.

Addressing Health Inequities and Infection Risks

Dr. Anna S. Lok, the Alice Lohrman Andrews Research Professor of Hepatology at Michigan Medicine and the first author of the commentary, highlights the importance of vaccinating all newborns. “We don’t know the status of every mother,” she explained. “The U.S. healthcare system has gaps, and many people lack insurance or arrive at the hospital late in labor. Vaccinating every newborn ensures that we do not overlook those with unknown hepatitis B status.”

Dr. Lok also pointed out that hepatitis B can be transmitted through more than just maternal contact. “Fathers and caregivers can also spread the virus,” she noted. “Even in daycare settings, the status of other children or caregivers is often unknown.” The risk of newborns contracting the virus is particularly high; if infected, they face a 90% chance of developing chronic infections, which significantly increases the risk of serious health complications later in life.

The Importance of Early Vaccination

The commentary underscores the necessity of vaccinating children early, as older age groups face more challenges in accessing vaccination services. “Getting babies vaccinated at birth is far more practical than trying to ensure adolescents and adults receive their vaccines later on,” Dr. Lok said.

The safety profile of the hepatitis B vaccine is robust. First approved in 1981, it is one of the few vaccines recommended for use in newborns and pregnant women, populations that are particularly vulnerable. “With more than one billion doses already administered, we have ample evidence of its safety and effectiveness,” Dr. Lok affirmed.

The overall message to parents and policymakers is clear: the timely administration of the hepatitis B vaccine at birth is essential for preventing chronic infections. “We have effective vaccines that can prevent serious health conditions,” she added. “It is the most cost-effective approach to avoid the long-term consequences of hepatitis B infection.”

As the call for universal vaccination continues, experts stress that the benefits of proactive health measures far outweigh the risks. Vaccination not only protects individual children but also contributes to broader public health efforts, reducing the incidence of hepatitis B in the community. Ensuring that every newborn receives this vital vaccine can lead to healthier futures and a significant reduction in the burden of disease associated with hepatitis B.