CDC Advisors Vote on Hepatitis B Vaccine, Review Childhood Immunization Schedule

In a recent meeting of the Centers for Disease Control and Prevention (CDC), outside advisors discussed significant adjustments to the childhood immunization schedule, particularly regarding the hepatitis B vaccine. The discussion included a comparative presentation between the U.S. vaccination schedule and that of Denmark.

Changing Recommendations for Hepatitis B Vaccine

The U.S. Food and Drug Administration’s Dr. Tracy Beth Hoeg presented a proposal to remove the universal newborn dose recommendation for the hepatitis B vaccine. She described the anticipated vote on this measure as a positive step. The intent is to align the United States’ vaccination practices more closely with those of peer nations.

Concerns Raised by CDC Experts

Dr. Adam Langer, a CDC expert on hepatitis B, voiced concerns regarding the comparison with Denmark’s immunization practices. He emphasized the unique aspects of the U.S. healthcare system and population dynamics.

Key Differences Highlighted

• Population Size: Denmark has a population of approximately 6 million, while New York City alone accounts for 8 million.
• Screening Rates: Over 95% of pregnant women in Denmark are screened for hepatitis B, a stark contrast to the U.S.
• Access to Healthcare: Prenatal care in Denmark is provided for free to citizens as well as refugees, unlike in the U.S.
• Health Registries: Denmark maintains a national health registry with comprehensive health data, which is absent in the U.S.
• Follow-Up Care: In Denmark, infants born to mothers who test positive for hepatitis B receive consistent follow-up care; the U.S. often lacks this continuity.

Dr. Langer argued that these differences indicate that Denmark and other high-income countries may not serve as ideal comparisons for U.S. health practices. He suggested that Canada could be a more appropriate benchmark but noted that there too, ongoing studies identify a universal birth dose for hepatitis B as essential for virus elimination.

Summary of the Meeting Insights

Dr. Langer concluded by urging a more accurate discussion of vaccination comparisons, stating, “Let’s talk about apples to apples, not apples to oranges.” Dr. Hoeg defended the proposal by asserting that the risks faced by newborns remain consistent, regardless of the healthcare system differences.

The upcoming vote on the hepatitis B vaccination recommendations marks a pivotal moment for public health policy in the United States as it seeks to balance effective healthcare with emerging global practices.