Could RFK Jr.’s Vaccine Committee Overturn Hepatitis B Vaccine?
Health Department Secretary Robert F. Kennedy Jr.’s Vaccine Advisory Committee will discuss and potentially postpone the critical immunization that protects infants from hepatitis B.
New mothers and their babies are likely to see changes in their preventive treatment after birth, thanks to the federal vaccine commission’s decision to weaken long-standing guidance on the hepatitis B vaccine.
For years, hospitals and birth centers have encouraged parents to do three things as soon as their children are born: give them a first dose of hepatitis B vaccine, a vitamin K shot, and an antibacterial eye ointment as part of a practice often called the “birth trifecta.”
But the Advisory Committee on Immunization Practices, which was overhauled by Secretary of Health and Human Services Robert F. Kennedy Jr. and included members who have been critical of vaccines, says only babies born to mothers who test positive for hepatitis B should be vaccinated at birth. They say other mothers should talk to their doctors about the vaccine, as experts say many babies will only receive two doses of the treatment at birth.
The committee said infants born to mothers who have not tested positive for hepatitis B should not receive their first hepatitis B vaccine until they are at least two months old. The Committee did not explain its rationale for why two months was an appropriate interval to wait. Additionally, because the current vaccine course requires three shots, the committee recommended that infants undergo blood tests to determine whether the first shot produced enough antibodies to protect against the disease before receiving the second shot.
Dr. Jennifer Lincoln, an obstetrician-gynecologist at an Oregon hospital, said the new advice means nurses at the hospital could tell new mothers that their test results were negative and that they should consult a medical professional before deciding whether (their baby) should undergo this series.
Mr Lincoln said 15% of pregnant women are not tested before giving birth, so they may not know in advance if they have hepatitis B. It said women receiving prenatal care are tested early in their pregnancy and could be exposed to the disease later on. She said that’s dangerous when dealing with a disease that is 100 times more contagious than HIV.
“You always end up with a Swiss cheese hole,” she says.
The rationale behind Hep B shot advice
The committee’s recommendations do not have the full force and effect of orders from the Centers for Disease Control and Prevention. But despite this, it is due to strong public outcry over the safety of the vaccine that doctors doubt the government will backtrack further from approving the vaccine. The country’s public health agency has widely recommended the vaccine since 1991.
The number of cases of hepatitis B, which causes liver disease and death, has declined in the United States since 1985, the CDC said in a news release. But while most doctors attribute this to previous universal vaccine recommendations, the CDC offered a different theory.
The agency attributed this decline to improvements in pre-transfusion screening, needle exchange programs and improved dialysis practices. Additionally, the CDC said less than 1% of infants are born to mothers who carry the antigen that can cause hepatitis B in their babies, and most of those mothers are immigrants from countries where hepatitis B is endemic.
“The American public has benefited from the committee’s informed and rigorous discussion of the appropriateness of vaccination in the first hours of life,” said CDC Acting Director Jim O’Neill.
Dr. Sandra Adamson Freihofer, director of the American Medical Association, said in a statement that the new recommendations are not based on scientific evidence or data and are instead “reckless and undermine decades of public trust in proven, life-saving vaccines.”
The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and several other medical groups said the new recommendations “will lead to an increase in hepatitis B infections in childhood, an increase in chronic infections that persist into adulthood, and complicate vaccine access for children.”
Doctor appointments are subject to change
Dr. Heidi Appel, a pediatrician and member of the Healthcare Protection Committee, said pediatricians still recommend that all newborns receive the vaccine.
But he said fewer babies were likely to be vaccinated as some parents would be confused by the new advice. Even parents looking to get their baby vaccinated at a future appointment may have to wait a long time to find a pediatrician or have their lives interrupted to get their newborn to the hospital, she says.
“People don’t necessarily make a one-month commitment. One month becomes two months, which becomes three months,” Appel said.
Lincoln, an Oregon native, agreed. She said she delayed getting her eldest son’s first hepatitis B shot for about a week because she felt uncomfortable about having him vaccinated at such a young age, which embarrassed her husband, a pediatrician. But she said she knows she and her husband don’t have the disease and will take the baby to a pediatrician soon.
Lincoln said while it was possible to make nuanced personal choices, not all new parents have access to the same level of testing or pediatricians, and public health agencies need to make recommendations for all parents.
“These recommendations today are not based on science and will confuse parents and the most vulnerable populations – those without high health literacy,” Lincoln said. He said many people may think vaccines are unsafe, but they are.
Appel encouraged parents to use the American Academy of Pediatrics website for reliable information about vaccines. She also said parents should choose their child’s pediatrician early and meet with that doctor before giving birth.
“Talk to them about vaccines, policy, etc.,” she said. “Let’s learn about it. That’s what we’re here for.”
