Colorado health officials are urging parents to continue immunizing newborns against hepatitis B, despite recent changes in federal guidelines that may result in fewer infants receiving the vaccine. The Centers for Disease Control and Prevention (CDC) advisory panel recently voted to shift from a universal recommendation for hepatitis B vaccination at birth to a “shared decision-making” approach between parents and medical providers.
UCHealth experts and leaders at the Colorado Department of Public Health and Environment remain committed to recommending the vaccine for all newborns within 24 hours of birth. They express concern that moving away from universal vaccination could increase the risk of babies contracting hepatitis B, which can lead to chronic liver disease later in life.
“If babies contract hepatitis B either during birth or shortly after birth, there’s a much, much higher chance that they’ll have it for the rest of their lives — and as a chronic condition, which has the higher risk for liver cancer, cirrhosis, etc.,” said Dr. Anna Euser of UCHealth University of Colorado Hospital.
Dr. Euser explained that since universal vaccination began in 1991, childhood hepatitis B infections in the United States have declined by 99%. She noted that many individuals with hepatitis B are unaware they are infected, making transmission to newborns possible even if mothers test negative before delivery. The virus is highly transmissible and can be spread through dried fluids on items like razors or toothbrushes.
“The other big-picture health benefit of giving it to every baby as a universal vaccine is that we’re not missing somebody who might not have had prenatal care or contracted hepatitis B since they had their prenatal labs,” Euser said. “We want to make sure that every baby is protected, so they have a much lower chance of hepatitis B becoming a chronic, lifelong condition.”
She added: “I did it for my kids. I wanted them to be protected against anything we could possibly protect them from.”
Hepatitis B is a virus attacking the liver and is transmitted via bodily fluids. Newborns infected at birth face a 90% chance of developing chronic infection; about 25% of those will die from the disease. Chronic infection also increases lifetime risk for liver cancer.
Universal newborn vaccination has been standard since CDC’s Advisory Committee on Immunization Practices (ACIP) recommended it in 1991. However, new federal officials at agencies including the U.S. Department of Health and Human Services have recently moved away from this approach—a change opposed by many state public health agencies such as Colorado’s.
The policy change could also affect private insurance coverage for newborn hepatitis B vaccines because insurers are required to cover vaccines recommended by ACIP without copays or deductibles. While major insurers have indicated no immediate changes, future coverage could be impacted if recommendations shift further.
Euser advises parents with questions about the vaccine to consult their medical providers: “If pregnant women have any doubts, they should speak with their medical providers, who are eager to keep both parents and their babies as safe as possible.”
