Foundation to follow medical societies' vaccine schedules in light of ACIP hepatitis B decision

The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices’ (ACIP) vote to end the recommendation that all newborns receive their first dose of the hepatitis B vaccine within 24 hours of birth is a step backward that puts immunocompromised people of all ages at greater risk.

Many people who are immunocompromised, including those with primary immunodeficiencies (PI), do not have immune systems that can mount a protective response to vaccines. Instead, people who are immunocompromised are best protected from infectious diseases like hepatitis B by never coming into contact with them in the first place. As an organization, the foundation must put the well-being of the primary immunodeficiency community first. The foundation will align its educational resources the with vaccine recommendations of the American Academy of Pediatrics (AAP) for those younger than 18 and the American Academy of Family Physicians (AAFP) for those 18 years of age and older as long as ACIP’s recommendations fail to adequately protect those who are most vulnerable.

Delaying the first dose of the hepatitis B vaccination series inevitably means that fewer children will be vaccinated against hepatitis B. Once released from the hospital, some will have missed their only chance at acquiring immunity to this virus. Hepatitis B is incredibly infectious, requiring contact with only microscopic amounts of infected blood or fluids to spread. As a result, the number of people in the U.S. living with chronic hepatitis B, an incurable disease that leads to liver damage and cancer, will increase.

By definition, more people living with chronic hepatitis B means more chance of coming in contact with the virus, putting those who are most vulnerable at higher risk of severe, preventable liver disease. Seventy-two million Americans, or 1 in 5 individuals, are at risk, including:

• The 14 million people 64 years of age or younger that are immunocompromised.
• All 58 million people 65 years of age or older, when the immune system naturally becomes weaker with age.

No new safety data on the hepatitis B vaccine was presented to the committee; there is no justification for removing the 30-year-old universal birth dose recommendation.

This vote has serious implications for those with PI and other immunocompromising conditions. A decrease in vaccination rates weakens community defenses against deadly germs and increases everyone’s exposure to them, putting those with compromised immune systems at a higher risk of preventable infections.

We urge the committee to reverse course and take actions to protect those who are immunocompromised by returning to the evidence-based vaccine schedules recommended by ACIP in the past.