Hepatitis B Vaccine Recommendation Change

Last week’s Advisory Committee on Immunization Practices (ACIP) meeting was concerning in both its outcome – a change in recommendations for universal hepatitis B (HBV) vaccination for all infants at birth – as well as what it foreshadows – significant changes in the Child and Adolescent Immunization Schedule.

The “birth dose” policy, adopted in 1991, has decreased the number of infants who contract HBV from about 9000 to about 20 per year. Previously, almost 90% of infants infected at birth developed chronic infection, with 1 in 4 dying early from cirrhosis or liver cancer. Because there is no medical treatment for chronic HBV infection, prevention is key. 

While screening of all pregnant women is recommended to occur at their first prenatal visit, ideally early in their pregnancy, this doesn’t always occur. Some newborns are exposed because of this, or because their mothers are infected later in their pregnancy after this initial screening has occurred. Lab tests can also be falsely negative. 

The West Coast Health Alliance and ACHD continue to recommend a “birth dose” of HBV vaccine as well as completion of the 3-dose series, with vaccinations at 1-2 months and 6-18 months. This series is 98% effective at providing lifelong protection.

Bob Lutz, MD MPH

Local Health Officer, Asotin County

You can read the Washington Department of Health press release about this recommendation change here