Sept 19 (Reuters) – An advisory committee of the Centers for Disease Control and Prevention has postponed a vote on a proposed change to the hepatitis B vaccination schedule for infants, which would have delayed the first dose from within 24 hours of birth to a later point in infancy or childhood, unless the mother is known to be infected.
Here’s what you need to know about the hepatitis B virus (HBV) and the vaccines.
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WHAT IS HEPATITIS B?
HBV attacks the liver and is the leading cause of liver cancer worldwide. Many infected people do not have symptoms and do not realize they are infected. In most adults who acquire the virus, the infection resolves on its own. But it becomes chronic in more than 90% of infants and in up to 50% of young children who become infected.
Decades after HBV infection, patients can develop liver failure and require a liver transplant. Because there is no cure for HBV infections, patients often have recurrent liver disease after a transplant.
HOW COMMON ARE HBV INFECTIONS TODAY?
U.S. HBV infection rates dropped nearly 90%, from about 9.6 per 100,000 before vaccination became widespread to approximately one per 100,000 in 2018.
HOW IS THE VIRUS TRANSMITTED?
Hepatitis B is most often acquired through contact with body fluids from an infected person. It can also be transmitted via needlestick injury, tattooing and piercing.
WHY IS THE VACCINE GIVEN TO NEWBORNS?
WHAT IS THE CURRENT VACCINE RECOMMENDATION IN THE U.S.?
Since October 2016, the CDC’s Advisory Committee on Immunization Practices (ACIP) has recommended that all medically stable newborns receive the first dose of the HBV vaccine within 24 hours of birth, followed by doses at 1-2 months and 6-18 months of age. This replaced the previous recommendation from 2005, which called for the initial dose to be given before newborns were discharged from the hospital.
If a mother is known to have an active HBV infection, the birth dose is given within 12 hours of birth along with special antibodies to fight the virus.
ACIP also recommends three doses of the vaccine for unvaccinated children and adults under age 60, and for older adults with risk factors for hepatitis B or without risk factors but seeking protection.
WHY TREAT ALL BABIES, NOT JUST THOSE WITH INFECTED MOTHERS?
Universal birth dosing protects infants whose parents’ HBV status is unknown or was not tested during prenatal care. Also, maternal testing can miss recent infections, making universal newborn vaccination more reliable.
Even when mothers are not infected, newborns can acquire HBV from close contact with other infected individuals.
Reporting by Nancy Lapid; Editing by Edmund Klamann
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Nancy has been a health news reporter and editor at Reuters for more than a decade, covering important medical research advances. She is the author of our twice-a-week Reuters Health Rounds newsletter.