Introduction to the Controversy
The hepatitis B vaccine has emerged as the latest flashpoint as Health Secretary Robert F. Kennedy Jr. continues to cast doubt on the safety of vaccines. The vaccine is routinely given to babies shortly after birth because hepatitis B — an incurable infection that can lead to liver disease, cancer and death — can be transmitted from mother to child during delivery.
The Debate Among Senators
At a Senate Finance Committee hearing with Kennedy on Thursday, Sen. Roger Marshall, R-Kan., said that providing the hepatitis B vaccine to all newborns “makes no sense to me,” especially if the mother tests negative for the virus. Marshall, an OB-GYN who said he’s delivered 5,000 babies, said he supports vaccinating the newborns of women who haven’t received prenatal care or who haven’t been tested for hepatitis B. But he questioned the need for universal vaccination.
He’s not the only Republican senator who’s been critical of the vaccine. “No medical reason to give newborns Hep B vaccine if mother is not infected. All mothers who deliver in a hospital are tested,” Rand Paul of Kentucky wrote on X last week. That prompted Sen. Bill Cassidy, R-La., to respond. “Empirically, this is not true. Not all mothers have prenatal care,” Cassidy wrote. “Some get infected between testing in the first trimester and delivery. In some cases, the test is overlooked.”
The Role of the CDC Committee
The issue isn’t likely to fade away anytime soon: Next week, a committee that advises the Centers for Disease Control and Prevention on vaccines is slated to discuss the hepatitis B vaccine. Kennedy fired all 17 members of the previous committee in June and handpicked seven replacements, several of whom have expressed anti-vaccine views. The new committee chair, Martin Kulldorff — a biostatistician who said he was fired from Harvard for refusing to get a Covid vaccination — cast doubt on the hepatitis B vaccine at the group’s first meeting in June. “Unless the mother is hepatitis B positive, an argument could be made to delay the vaccine for this infection,” Kulldorff said.
Why Newborns Get the Hepatitis B Vaccine
Doctors vaccinate babies on the first day of life because that’s when the vaccine is most effective, Dr. Ravi Jhaveri, head of infectious diseases at Lurie Children’s Hospital of Chicago. When infants are infected during childbirth, the hepatitis B virus enters their bloodstream and heads for the liver, where it can set up a lifelong infection, Jhaveri said. Vaccinating newborns just after delivery gives their immune system the chance to fight off the infection quickly, rather than allowing the virus to multiply and gain a foothold. Studies show that vaccinating older babies exposed to hepatitis B isn’t effective, he said.
The Importance of Vaccination
Hepatitis B spreads through contact with infected blood and bodily fluids — even microscopic amounts — and is incredibly infectious. Children can be infected in the home by people with the virus, especially if they share toothbrushes, razors and earrings, Cohen said. Vaccinating newborns before they leave the hospital protects them from being infected throughout childhood. Dr. Su Wang, an internal medicine doctor, learned she had hepatitis B after donating blood when she was in college. Although her mother did not have the disease, other family members did. Wang takes antiviral medicine for hepatitis B and remains healthy. She said she made sure that all four of her children got the vaccine when they were born, along with a dose of hepatitis B immunoglobulin, which provides the body with extra antibodies.
The History of the Hepatitis B Vaccine
When the hepatitis B vaccine was first introduced in 1982, doctors provided it only to adults at high risk. Two years later, the CDC recommended the vaccine for high-risk newborns, Jhaveri said. The number of perinatal infections stayed stubbornly high. But hepatitis B infections plummeted after the CDC began recommending a universal dose of hepatitis B vaccine at birth in 1991. Cases of acute hepatitis B infections among children fell 99% from 1990 to 2019. Infection rates remained the same or increased among adults over 40 from 2010 to 2019. Vaccinating babies appears to protect them for at least several decades, Jhaveri said.
What to Know About Hepatitis B
When adults are infected with hepatitis B, their immune system often overcomes the virus, so that it’s no longer a threat, Campbell said. Babies, whose immune systems are undeveloped, typically develop chronic infection for the rest of their lives. The longer that people live with the chronic inflammation caused by infection, the higher their risk of liver damage and cancer, Cohen said. No child should develop cancer from a preventable infection, she said. “We want to give every baby born in the U.S. the absolute right to a long healthy life,” she said, “not an increased risk of cancer from the day they’re born.”
Conclusion
The debate surrounding the hepatitis B vaccine is complex and multifaceted. While some argue that the vaccine is unnecessary for newborns whose mothers test negative for the virus, others point to the vaccine’s proven track record in preventing the spread of hepatitis B. As the CDC’s vaccine panel prepares to discuss the hepatitis B vaccine, it is essential to consider the potential consequences of altering the current vaccination schedule. The hepatitis B vaccine has been shown to be safe and effective, and it has played a crucial role in reducing the number of hepatitis B infections in the United States.
FAQs
- Q: What is hepatitis B?
A: Hepatitis B is an incurable infection that can lead to liver disease, cancer, and death. - Q: Why do newborns get the hepatitis B vaccine?
A: Newborns get the hepatitis B vaccine to protect them from the virus, which can be transmitted from mother to child during delivery. - Q: Is the hepatitis B vaccine safe and effective?
A: Yes, the hepatitis B vaccine has been shown to be safe and effective in preventing the spread of hepatitis B. - Q: What are the risks of not vaccinating against hepatitis B?
A: The risks of not vaccinating against hepatitis B include chronic infection, liver damage, and cancer. - Q: How common is hepatitis B in the United States?
A: Hepatitis B is relatively rare in the United States, thanks in part to the widespread use of the hepatitis B vaccine. However, it is still a significant public health concern, particularly among certain high-risk groups.
