Decisions in Washington – and recently in Atlanta – sometimes are helpful, sometimes unhelpful, and sometimes simply puzzling. A good example is the federal vaccine advisory committee’s vote this past week to end the Centers for Disease Control and Prevention (CDC) recommendation for immunizing babies at birth against hepatitis B vaccine.
New mothers need to make decisions at birth about protecting their babies from disease. Standard care following delivery is to apply erythromycin eye ointment (to protect babies from eye infections that may cause blindness), an injection of vitamin K (to prevent bleeding while the newborn’s own production of vitamin K is still developing) and to inoculate against hepatitis B infections.
The CDC’s new recommendation is to delay the first dose of the hepatitis B vaccine (it is a three-part series) until the baby is two months old. The recommendation is still to give the vaccine – just to wait for two months. In the past, this committee followed the advice of the American Academy of Pediatrics. This academy represents about 67,000 pediatricians and is the most important and most reliable source of information about the health of babies and children. Not following the recommendation of 67,000 pediatricians is simply amazing. This recommendation began in 1991. Since then, hepatitis B infections have decreased by 99% in children and teenagers.
If following the CDC’s advisory committee’s recommendation to wait two months, the baby would be at risk for two months! People can be infected with hepatitis B but not show symptoms. Even if the mother has been tested and is negative, everyone (dad, relatives, neighbors, daycare staff) and everything around the newborn (towels, blankets, sheets with tiny amounts of infectious blood) could potentially transmit hepatitis. And getting hepatitis B as an infant means a lifetime of possible liver impairment, including a greatly increased risk of cancer and cirrhosis.
With this vaccine being administered routinely since 1991, we have an incredibly strong record of its success and lack of side effects. The medical community agrees that giving your newborn protection from hepatitis B protects your baby, and the enormous historical record shows that this benefit is many, many times stronger than the possibility of something bad happening
Unclear is what this means in our local hospitals. Most likely, recommended care will continue to include eye cream ointment, vitamin K, and hepatitis B protection. The medical community trusts the medical community more than it trusts big government. Of course, you can find nay-sayers (to about anything) on the web, but they are lonely voices against the Academy representing 67,000 pediatricians. The CDC’s new recommendation is largely understood as a political decision rather than a medical decision – new mothers here will need to decide who to listen to.
