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Two new studies published this week in the Journal of the American Medical Association (JAMA) demonstrate that delaying hepatitis B vaccines for newborns, as outlined in guidelines issued by the Centers for Disease Control and Prevention (CDC) earlier this year, will likely lead to hundreds of additional infections each year, resulting in millions of dollars in lifetime costs.
Prior to the CDC’s changes, the hepatitis B vaccine was recommended for every infant in the U.S., to be administered around the time of their birth. The new vaccine schedule — issued by a panel within the CDC filled primarily with individuals appointed by noted anti-vaxxer Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. — removes hepatitis B from the list of vaccines recommended for children at birth, instead advising that newborns receive the shots starting at two months of age after parents consult with a medical provider.
Those changes could have dire health and economic consequences for children and their families, the studies found, affecting them throughout their entire lives if they become infected with the virus.
One of the JAMA-published studies found that delaying the first dose of a hepatitis B vaccine by two months for most children in the U.S. would result in “$16.4 million in added costs for infants born during 1 year.” The second study that was published estimates that an additional 628 infants will become infected with hepatitis B each year if only 10 percent of babies are in line with the previous policy of obtaining a vaccine dose at birth.
“One of the most concerning implications is how many more infected hep b babies will we see,” said Rachel Epstein, a pediatric and adult infectious diseases clinician at Boston Medical Center who co-authored the second study. “A universal birth dose helps prevent a substantial number of infections in babies of a lifelong condition that we do not have a cure for.”
Arthur Reingold, emeritus professor of epidemiology at the University of California, Berkeley, told The Washington Post that both studies were conducted properly.
“These 2 studies were exceptionally well done and rigorous in their approach, assumptions, calculations, and conclusions,” Reingold said in an email to the publication.
Conversely, Reingold pointed out that the changes to the hepatitis B vaccine schedule (as laid out by the CDC) seem to have ignored scientific standards.
“The hepatitis B birth dose has been given to tens of millions of children in the United States and hundreds of millions around the world. And there’s simply not a shred of evidence that there are any adverse effects or safety concerns,” he said.
Indeed, the Trump administration insisted that the changes were primarily made to align the U.S. vaccine schedule with those in European countries. But health experts note that different countries have differing health needs and challenges, and that there is no single approach to immunization.
“I do not think this makes sense scientifically,” Anders Hviid, an official in Denmark’s Statens Serum Institute, said when the changes in the U.S. were implemented. “Public health is not one size fits all. It’s population-specific and dynamic. Denmark and the U.S. are two very different countries.”
Hepatitis B is primarily passed through sexual contact, a point the administration made in justifying the delay. But the virus can also be passed through blood or saliva. Delays in vaccination for hepatitis B could make transmission at daycare centers or other places where infants or children interact more likely.
In March, a federal judge placed a hold on the newly implemented vaccine schedule, finding that the CDC’s vaccine board was improperly formed when Kennedy vacated its previous members and appointed new ones.
“There is a method to how these decisions historically have been made — a method scientific in nature and codified into law through procedural requirements. Unfortunately, the Government has disregarded those methods and thereby undermined the integrity of its actions,” Massachusetts-based U.S. District Judge Brian Murphy wrote in his order.
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