Scathing American public health experts are pushing back against doubts and criticisms about the hepatitis B vaccine spread by Health Secretary Robert F Kennedy Jr and his allies, saying his arguments “make no sense”.
Since overhauling the Centre for Disease Control (CDC) Advisory Committee on Immunisation Practices (ACIP), Kennedy and his supporters have questioned the vaccine's safety and the need for a birth dose, reports Medpage Today.
However, those assertions could erode public confidence in a vaccine credited with virtually eliminating childhood transmission of the virus in the United States, health professionals said.
“To be pulling back on a safe vaccine that prevents liver disease and liver cancer in children and adults just makes no sense,” said Kristen Marks, MD, an infectious disease specialist at Weill Cornell Medicine in New York City.
In a media interview recently, vaccine sceptic Kennedy had claimed knowledge of a CDC study linking the hepatitis B jab to autism that he said was hidden from the public. He claimed it showed a “1 135% elevated risk of autism” among vaccinated children but was “manipulated … through five different iterations to try to bury the link”.
No credible evidence exists that such a study was ever conducted. MedPage Today asked HHS for a copy of it, but agency spokesperson Emily Hilliard did not address the request.
“I’ve never seen, nor do I know of anyone who’s ever seen, such a study,” Hepatitis B Foundation President Chari Cohen, DrPH, MPH, told MedPage Today.
“What we do know is that there is no link between the hepatitis B vaccine and autism.”
The viral liver infection can raise the risk of cirrhosis and liver cancer. It can be acute or chronic, and it is spread through contact with infected bodily fluids, including blood, saliva, semen, and vaginal secretions.
The World Health Organisation (WHO) estimates that 97m people in the Western Pacific region and 5m in the Americas have the infection.
In the US, public health recommendations call for a three-dose series for children to be given at birth, one-two months, and six months or later.
“The vaccine, introduced in 1981, has a fairly long track record of safety and efficacy,” said Jesse Hackell, MD, of New York Medical College in Valhalla and the chair of the American Academy of Paediatrics (AAP) Committee on Paediatric Workforce.
“There have not been any safety signals … in ages,” he said. “If there were something going on there, I think we would see issues, we’d see signals coming out, and that would lead to investigation. So in terms of safety, I don’t have any concerns."
Martin Kulldorff, PhD, the former Harvard Medical School professor Kennedy tapped to chair the revamped ACIP, marked his first meeting by questioning whether it was “wise” to give shots “to every newborn before leaving the hospital” when the disease “is primarily spread by sexual activity and intravenous drug use”.
That’s not accurate, Cohen said. In highly endemic areas, hepatitis B is most commonly spread from mother to child at birth, according to the WHO.
“It’s primarily transmitted through blood exchange that happens during the childbirth process,” Cohen said. “That’s why we give the birth dose of hepatitis B vaccine to babies. It is to prevent babies from getting transmission – either at birth, or when they go home and have family who are helping take care of them.”
Marks urged the committee to understand the pathogenesis of the infection.
“Being exposed as an infant almost always results in chronic infection,” she said. “So that’s why it's key to get vaccinated at that time.”
Initially, the hepatitis B vaccine was targeted to adults with specific risk factors.
“It soon became apparent that risk factor-based vaccination in adults doesn’t work very well,” William Schaffner, MD, of Vanderbilt University Medical Centre in Nashville, Tennessee, told MedPage Today.
In 1991, ACIP began recommending universal infant vaccination, a change that produced dramatic results. The rate of acute hepatitis B among children aged one to nine years old dropped by more than 80% from 1986-2000.
Between 2011 and 2022, the rate among those 19 and younger was fewer than 0.1 cases per 100 000, according to CDC data. The AAP reported only 17 perinatal hepatitis B cases in the US in 2021 and 13 in 2022.
“We have profoundly diminished the occurrence of hepatitis B in children, in adolescents, and young adults,” Schaffner said. “This has been a remarkably effective means … creating an immune population in the United States. They’ll soon be in their 30s and 40s and 50s, and they’ll take that protection that they received at birth with them through life, and we will get progressive reduction in adult age groups.”
The HHS spokesperson said the agency is “not commenting on future or potential policy decisions”.
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