Hepatitis B could surge, infecting millions more in childhood, under proposed CDC guidance

A new modeling study predicts that a proposed change to CDC guidance on hepatitis B vaccination could lead to a significant increase in chronic HBV infections among young people in the United States. Currently, the CDC recommends universal birth-dose vaccination for all newborns within hours of birth, but the Advisory Committee on Immunization Practices (ACIP) recently advised ending this recommendation.

The CDC accepted this advice and now proposes that birth doses of the vaccine be given only to babies whose mothers are positive for HBV or whose status is unknown. Mothers who test negative are advised to discuss with their doctors whether their child needs a birth dose. The modeling study predicts that if this change were implemented, there would be a 19% increase in chronic HBV infections by age 20 among babies born in 2026 compared to universal birth-dose vaccination.

This would translate to approximately 1.8 million additional cases of chronic HBV infections among young adults, increasing the risk of liver scarring, liver cancer, and other chronic liver diseases. The study emphasizes that the birth-dose strategy is more effective in preventing chronic HBV infections than the proposed shared clinical decision-making approach.