Breaking from a position it held for 34 years, the CDC said Dec. 16 it recommends shared decision-making between parents and clinicians on whether to administer the first hepatitis B vaccine to infants whose mothers test negative for the virus.
Since 1991, the agency recommended vaccinating all healthy newborns against hepatitis B either within 24 hours or before hospital discharge, regardless of whether the mother tested positive or negative for the virus.
Five things to know:
1. The CDC’s new recommendation aligns with the Advisory Committee on Immunization Practices, which voted Dec. 5 in favor of changing national guidance for the three-dose series for hepatitis B. For infants who do not receive the birth dose, the agency said “it is suggested that the initial dose be administered no earlier than two months of age.”
Notably, the CDC did not adopt — but is reviewing — ACIP’s recommendation for post-vaccination serology testing on whether a child needs additional hepatitis B vaccine doses.
2. Hepatitis B is a liver infection that can range from a mild, weekslong illness to a serious, chronic illness, which can cause liver damage, cirrhosis, liver cancer and death. Many hepatitis B cases are asymptomatic, according to the CDC.
3. The vaccine series, historically, advised clinicians to administer the first dose within 24 hours of birth among infants who weigh at least 4.4 pounds and are medically stable, or the first dose at hospital discharge or when the infant is 1 month old, whichever is first.
The second dose is recommended for infants between 1 and 2 months old, and a third dose between 6 and 15 months old.
4. Some states are breaking from the CDC’s guidance. The Illinois Department of Public Health Immunization Advisory Committee, for example, voted unanimously Dec. 16 to recommend the hepatitis B vaccine to nearly all newborns, according to the Chicago Tribune.
5. The American Academy of Pediatrics, which characterized the revised guidance as “irresponsible and purposely misleading,” said the CDC’s decision to shrink hepatitis B vaccine recommendations will result in more hepatitis B infections.
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