Today the American Academy of Pediatrics (AAP) released new infant guidelines for hepatitis B vaccinations.
The organization now recommends that healthy newborns — medically stable and having a minimum birthweight of 2,000 grams — receive the first dose of the vaccine within the first 24 hours of birth.
Previous recommendations contained “permissive language,” which allowed for an option to delay the initial dose until a baby’s first checkup.
The AAP emphasizes that performing the inoculation shortly after birth maximizes the effectiveness in preventing newborn infection.
Researchers discovered in a 2014 study, that only 72 percent of infants actually received the birth dose of the vaccine — significantly below the target of 85 percent.
Current hepatitis B vaccinations have already proved effective, but there are still roughly 1,000 perinatal cases — meaning the infection is passed from mother to child — of the disease identified in infants annually in the United States.
The U.S. Department of Health and Human Services has announced a goal of cutting down the number of perinatal transmissions of hepatitis B by 2020.
Preventing a chronic and potentially fatal disease
Hepatitis B is a liver infection transmitted through blood and other bodily fluids. It can be passed on through sexual contact, as well as needle-sharing, which can occur in injection drug users.
The disease is often an acute, short-term illness, but it can become a chronic infection. Chronic hepatitis B can lead to liver damage, failure, cancer, and even death. Infant immunization is particularly important because, unlike adults, they are more prone to the development of the chronic form of the disease.
According to the Centers for Disease Control and Prevention (CDC), about 90 percent of infected infants develop chronic hepatitis B, compared with only 2.6 percent of adults.
Ninety-eight percent of healthy children who complete the full series (3-4 separate shots) of the hepatitis B vaccination achieve complete immunity to the disease.
Opioid crisis partially to blame
When the original vaccine was introduced in 1982, it resulted in an immediate 90 percent reduction rate in new infections. Now the AAP is pushing for a renewed effort in preventing infant hepatitis B transmission, partially in response to the ongoing opioid epidemic.
“The national opioid epidemic has led to an increase in new hepatitis B infections in some states,” said Dr. Karen Puopolo, a co-author of the new AAP guidelines, in a press statement. “Infants are especially vulnerable to infection at the time of birth, and need the maximal protection provided by administering the first vaccine dose shortly after birth.”
The increase in injection drug use linked with the opioid crisis has also caused an uptick in other serious diseases, including syphilis.
Guidelines likely to meet resistance from skeptical parent groups
Although not addressed in the new AAP statement, the issue of vaccine hesitancy is relevant. While anti-vaccination theories about the link between inoculations and autism have been disproven, there are still parents who are skeptical of vaccinations, which can result in delayed, altered, or incomplete vaccinations.
In his 2007 book “The Vaccine Book: Making the Right Decision for Your Child,” Dr. Robert Sears, the son of well-known pediatrician William Sears, popularized the idea of alternative vaccine schedules for infants.
He warns of the “chemical overload” potential of giving numerous vaccinations to children.
However, there is no medical research to back up his claims.
Nonetheless, vaccine hesitancy is on the rise. An AAP report from 2016 revealed that the number of pediatricians who encountered parents that refused the vaccine increased from 75 percent to 87 percent between 2006 and 2013.
Currently, infants receive 14 different vaccines by age 2, sometimes receiving up to five shots in a single visit.
“Infants and young children who follow immunization schedules that spread out shots — or leave out shots — are at risk of getting sick,” Dr. Allen Craig, deputy director of the CDC’s National Center for Immunization and Respiratory Disease, told Healthline in July.
That is also clearly true for hepatitis B. The AAP’s new guidelines actively eliminate the potential for a delayed dose, and instead recommend it always be administered within 24 hours of birth.
“This is the first vaccine a baby receives. It is important that no newborn leaves the birth hospital without it.” Dr. Flor Munoz, a co-author of the guidelines, said in the press statement.