Health authorities in Arizona are choosing to uphold a longstanding health measure amidst new national recommendations suggesting otherwise. The state’s health department will continue advocating for hepatitis B vaccinations for all newborns within the first 24 hours of life, despite a new advisory from the Centers for Disease Control and Prevention (CDC) suggesting a more selective approach.
Dr. Joel Terriquez, leading the Arizona Department of Health Services’ infectious disease and immunization bureaus, strongly opposes the CDC’s altered guidance. He argues that the benefits of early hepatitis B vaccination significantly outweigh the potential risks. Terriquez asserts that straying from this practice could increase the number of children facing severe health issues and possibly needing liver transplants.
The CDC’s Advisory Committee on Immunization Practices—composed of members selected by Health and Human Services Director Robert F. Kennedy Jr.—recently voted 8-3 to revise its stance. The new guidelines propose vaccinating only newborns of mothers who test positive or have an unknown health status for hepatitis B. However, Terriquez criticizes this decision, emphasizing that the vaccine’s historical effectiveness and safety are being overlooked.
Reflecting on the past, Terriquez recalls that before the standardization of the vaccine in 1991, newborns faced a staggering 90% chance of developing acute infections, leading to serious complications like cirrhosis and liver failure. “Treatment is very complicated,” he stated, emphasizing the high cost, side effects, and limited availability of liver transplants.
Hepatitis B transmits through bodily fluids such as blood and semen, with potential spread during childbirth from infected mothers to their infants. This transmission risk originally led to the recommendation for universal newborn vaccination.
According to Terriquez, the CDC’s revised recommendation assumes all mothers have been adequately tested for hepatitis B immunity during pregnancy. Yet, he warns this assumption could prove dangerous, as some mothers may not receive timely prenatal care, leaving a gap of up to nine weeks before the infection is detectable. Such delays could prevent newborns from receiving the critical initial vaccine dose, heightening their risk of severe health issues.
Committee member Joseph Hibbeln echoed these concerns during the panel discussion, stressing the potential harm of the new recommendation. “This has a great potential to cause harm,” he stated. The final decision on this recommendation rests with Jim O’Neill, the CDC’s acting director.
U.S. Senator Bill Cassidy, a medical doctor and chair of the Senate Committee on Health, Education, Labor and Pensions, has urged O’Neill to reject the recommendation, labeling it a “mistake.” Cassidy noted that before the routine birth dose, hepatitis B infections in newborns numbered 20,000 annually, compared to less than 20 now.
While the panel suggests that mothers testing negative can decide with their doctors whether to vaccinate, they recommend administering the vaccine no earlier than two months post-birth. Dr. Kirk Milhoan, committee chair, believes this timing allows infants to mature beyond the neonatal stage, but Hibbeln argues there’s no evidence supporting this delay, calling it “unconscionable.”
Terriquez warns that delaying vaccination increases risks for infants born to infected mothers, as newborns cannot clear the infection as adults might. He stresses the importance of early vaccination to avoid missed opportunities for preventing severe complications.
The potential impact of the CDC’s recommendation on insurance coverage for the vaccine remains uncertain. Nonetheless, the federally funded Vaccines for Children Program ensures free vaccines for eligible children, including those uninsured or underinsured. Terriquez noted discussions are ongoing about the program’s future if the CDC changes its guideline.
Kennedy, known for his vaccine safety skepticism before joining President Trump’s Cabinet, reshuffled the advisory committee, asserting a need to restore public trust in vaccine science. The panel has since made controversial decisions, including revising COVID vaccine recommendations for younger populations.
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