By Dr. Kristina Adams Waldorf and Catherine Lirtsman
What is Hepatitis B?
Hepatitis B is a highly contagious virus that attacks the liver. The infection can be acute, or short term, but may alarmingly progress to chronic, or long term, liver issues including cirrhosis, liver cancer, and death. The virus can be transmitted via bodily fluids, blood, mother to child, and live on surfaces for up to a week. Up to 50% of people infected with Hepatitis B do not know they have the virus and can unknowingly infect those around them. Fortunately, vaccination against Hepatitis B has been immensely successful at reducing infections worldwide, predicting to prevent about 38 million deaths in any children born between 2000-2030.
The Increased Hepatitis B Risk for Newborns
Infants are particularly vulnerable to Hepatitis B infection as the virus is passed easily from mother to baby during childbirth. This virus can also be spread by other caregivers or household members through surfaces, minor cuts, or small amounts of blood. Infants have underdeveloped immune systems, therefore Hepatitis B causes chronic disease in about 90% of cases. Newborns may be asymptomatic during the acute infection but go on to develop the disease later in life. Tragically, 25% of Hepatitis B infected children die prematurely.
Hepatitis B Vaccine at Birth and its Proven Safety
In 1991, the Advisory Committee for Immunization Practices recommended the Hepatitis B vaccine be administered at birth. This is followed by a 3-4 dose series. Due to these vaccine recommendations, cases of childhood Hepatitis B have dropped dramatically. Now, transmission of the virus to children younger than 19 has dropped by 99%.
The benefits of starting vaccination with a dose at birth:
• 90% effective for preventing infection acquired from childbirth.
• After proper vaccination, 98% of infants attain immunity to Hepatitis B for at least 30 years.
• Vaccination at birth reduces risk of liver disease by 70% and liver cancer by 84%.
The Hepatitis B vaccine is scientifically proven to be safe for newborns. After decades of monitoring by the Center for Disease Control (CDC) of administration of the vaccine at birth has shown no increased risk of death, sepsis, multiple sclerosis, or any other safety concerns.
Read more here: https://www.cdc.gov/vaccine-safety/vaccines/hepatitis-b.html#cdc_generic_section_7-a-closer-look-at-the-safety-data
Understanding the 2025 CDC Vaccine Panel Ruling
At a December meeting, the CDC’s Advisory Committee on Immunization Practices voted to end the universal recommendation of Hepatitis B vaccine administration at birth if the pregnant mother tests negative for the virus. The decision for vaccination at birth is now up to the determination of the parents and their healthcare provider. The birth dose is now recommended only if a mother tests positive for Hepatitis B or has not been tested. The updated recommendation is for infants to begin receiving their Hepatitis B series at 2 months of age.
While the vaccine will still continue to be available and covered by most insurers, the change in policy may create a misleading impression of scientific uncertainty. Committee member Vicky Pebsworth cited reasons for reassessing the recommendation was due to “pressure from stakeholder groups wanting the policy to be revisited” not because of updated scientific safety information.
The American Academy of Pediatrics asserts that the importance of vaccinating newborns for Hepatitis B at birth to prevent infections from childbirth and throughout childhood. Without the birth dose, newborns may still be at risk if the mother’s Hepatitis B test result is a false negative, the mother acquires the infection after testing, or if another household member is positive. Early vaccination can prevent serious liver diseases and cancer. With a long record of safety, the Hepatitis B vaccine ensures protection of vulnerable newborns from the lifelong risks of an infection.
Read more here: https://www.aap.org/en/news-room/fact-checked/fact-checked-hepatitis-b-vaccine-given-to-newborns-reduces-risk-of-chronic-infection/?srsltid=AfmBOora5mc-FP1OVqiFL_A7IyJESdfxAWgXolXx7lErqHft9T34mQG6
https://www.acog.org/womens-health/faqs/protecting-yourself-against-hepatitis-b-and-hepatitis-c
Kristina Adams Waldorf, MD is a Professor of Obstetrics and Gynecology and Adjunct Professor of Global Health at the University of Washington School of Medicine. She is an internationally recognized expert in how infections impact pregnancy and how vaccines and therapeutics protect the mother and fetus. She is Chair of the National Institutes of Health Obstetrics and Maternal-Fetal Biology Study Section. She is a member of the Center for Reproductive Sciences and the Center for Innate Immunity and Immune Diseases. Her grant support has come from the National Institutes of Health, the March of Dimes, Burroughs-Wellcome Fund, the Canadian Institute for Health Research and the Australian National Medical Research Council.
Catherine Lirtsman is a fourth-year undergraduate at the University of California, Los Angeles pursuing a Bachelor of Science in Human Biology and Society. She has been involved in research on influenza virus receptor distribution in the placenta and the cytokine reaction to group B streptococcus in placental tissue. Currently, she is an undergraduate research assistant in the Kallapur Lab at the David Geffen School of Medicine. She is passionate about OB-GYN research and is dedicated to improving maternal and fetal survival rates.