work out tribally owned hospital Brian McMahon, a hepatologist in Anchorage, Alaska, has spent decades treating the long shadow of hepatitis B. Before vaccines became available in the 1980s, he saw the virus claim young lives at an alarming rate in his western Alaskan communities.
One of his patients was 17 years old when he was first examined for abdominal pain. Just weeks before he graduated from high school as valedictorian, McMahon discovered he had liver cancer caused by hepatitis B. She died before the event.
McMahon often thinks about the 8-year-old boy who showed no symptoms until he started complaining of pain from a rapidly growing tumor in his liver.
McMahon can still hear his voice.
“I groaned in pain, saying, ‘I know I’m going to die soon,’” he recalled. “We were all crying.” The boy died at home a week later.
Hepatitis B virus is transmitted through blood and body fluids, even in minute amounts, and the virus can survive on surfaces for up to a week. Like many of her patients, McMahon said both of her children contracted hepatitis B at birth or during childhood.
Now you can prevent the consequences. Since 1991, a maximum of one birth dose has been recommended for newborns. 90% effective When administered within 24 hours of birth, it helps prevent infection from the mother. If your baby receives all three doses: 98% of them You have immunity to an incurable virus, and that protection should at least last. 30 years.
In western Alaska communities, years of targeted testing and widespread vaccination efforts have resulted in: The number of cases is plummeting.
“Liver cancer has disappeared in children,” McMahon said. “We haven’t seen a case since 1995. “Also, as far as we know, there are no children under 30 who have been infected.”
He worries that his hard-earned gains could soon be rolled back.
Are you pushing your dose back?
Health and Human Services Secretary Robert F. Kennedy Jr. will appoint a Centers for Disease Control and Prevention vaccine advisory group. to discuss and vote A two-day meeting from December 4 discussed the recommended birth dose for hepatitis B, potentially limiting access to children.
On Tucker Carlson’s podcast last June, Kennedy falsely claimed that a birth dose of hepatitis B was a “probable cause” of autism.
He also said that the hepatitis B virus “is not transmitted accidentally.” but Decades of Research It shows that the virus can be transmitted through indirect contact when traces of infected body fluids, such as blood, enter the body, when people share personal items such as razors or toothbrushes.
The committee’s recommendations are important. Most private insurers are required to cover vaccines approved by the Advisory Committee on Immunization Practices, and many states’ immunization policies are directly tied to that guidance.
Neither ACIP nor CDC are regulated. Vaccination cannot be mandated. that until the week To do that. However, maintaining the hepatitis B vaccine recommendation at birth preserves the widest range of options for families. They can be vaccinated at birth, wait until after childhood, or not vaccinate at all, and insurance will continue to cover the cost of the vaccinations as long as they are approved by the Food and Drug Administration (FDA).
Two senior FDA officials—Director Marty Makary and top vaccine regulator Vinay Prasad—suggested in late November: changes A vaccine approval process may be approaching. The vaccine must be approved by the FDA to be administered in the United States.
in Internal agency email acquired by PBS NewsHour and washington postPrasad questioned the routine practice of “administering multiple vaccines at the same time.” It is unclear whether he was referring to combination vaccines that provide immunity against multiple diseases in one shot. Of the nine hepatitis B vaccines currently approved by the FDA, three are combination vaccines. that birth dose The hepatitis B vaccine is administered as a standalone vaccine.
‘Sowing distrust’
Even if private insurers still decide to cover the vaccine, she said, misinformation from the meetings could still lead families to mistakenly believe the vaccine could harm their baby. Sean O’LearyHe is Chairman of the Committee on Infectious Diseases of the American Academy of Pediatrics and Assistant Professor of Pediatrics at the University of Colorado School of Medicine.
“Everything that comes out of the disaster of the December meeting will be designed primarily around sowing distrust and spreading fear,” he said.
President Donald Trump, Kennedy, and some newly appointed ACIP members have mischaracterized how the liver disease spreads and ignored or downplayed the risk of transmission through indirect contact. Hepatitis B virus is much more contagious Better than AIDS. Unvaccinated people, including children, can become infected from tiny amounts of blood on a table or on a toy, even if the infected person is asymptomatic.
McMahon cared for children who tested negative at birth and later became infected through indirect contact. at Studying in the 1970sNearly a third of those children have chronic hepatitis B without showing any symptoms, he said.
“It’s a very contagious virus,” McMahon said, “so giving everyone a birth dose is the best way to prevent it.”
The CDC recommends that all pregnant women get tested for hepatitis B, but it is estimated that up to 16% fail because they do not get tested. O’Leary and other experts say it’s impossible to test mothers for the virus right before or after giving birth because most hospitals are short on staff and resources.
The three-dose vaccine has the following characteristics: long track record Of safety. Many studies show that it is not associated with an increased risk of: infant death, fever or sepsis, multiple sclerosisor autoimmune diseaseSerious reactions are rare.
“We have an incredible safety profile,” O’Leary said. “No one expects to get into a car accident, right? Still, we all wear seat belts. This is similar.”
The CDC estimates that 2.4 million people in the United States have hepatitis B, half that many. don’t know They are infected. This disease can range from acute to chronic infection and often presents with symptoms such as: Few or no symptoms. If left untreated, the disease can lead to serious conditions such as cirrhosis, liver failure, and liver cancer. There is no cure.
Expert advice for parents: Talk to your doctor
William SchaffnerThe professor of preventive medicine at Vanderbilt School of Medicine and former ACIP member said some parents struggle to understand why healthy newborns should be vaccinated immediately after birth. In particular, we are often convinced that there is no virus and incorrectly associate it only with risky behavior. He said this perception is mixed with declining trust in public health and increasing skepticism about vaccines.
His advice to worried parents-to-be is to talk to your doctor about shots. He said even if a pregnant woman tests negative, it is still important to give the baby a dose at birth because false negative tests are possible and the virus can easily spread through surface contact. Babies who receive a full series of vaccines from birth are likely to: 84% reduction in liver cancer.
“If you wait a month and the mother tests positive or the baby gets the infection from a caregiver, by then the infection will be established in the baby’s liver,” Schaffner said. “It’s too late to prevent infection.”
He said that as fewer people get vaccinated, hepatitis B will spread at a higher rate in American society, increasing the risk of contracting the virus for everyone who is not vaccinated.
And an increase in hepatitis B cases could mean increased costs for patients and a strain on the health care system. The CDC estimates that it costs between $25,000 and $94,000 per year to treat a person with a less severe form of the disease. For patients who need a liver transplant, annual medical costs can rise to more than $320,000, depending on treatment options.
Over the past 30 years, major side effects Parents reported that their baby fussed or cried after receiving the birth dose, both of which passed quickly. Schaffner said this is a very strong safety profile for a neonatal vaccine with a track record of protecting babies from terminal diseases.
“The data on this is very clear,” Schaffner said. “Now, many different countries have started this program. They are using us as a model.”
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