Rhode Island Response to Hepatitis B Vaccination Vote

The Rhode Island Department of Health (RIDOH) continues to firmly recommend that all newborns receive a hepatitis B vaccine birth dose within 24 hours of delivery, regardless of the hepatitis B infection status of the birth parent, and that all children complete the full vaccination series within 18 months.

Late last week, the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) voted to recommend individual-based decision-making for parents for the hepatitis B vaccine, including the birth dose, to infants born to women who test negative for the virus. For those infants not receiving the birth dose, ACIP suggested in its recommendation that the initial dose be administered no earlier than 2 months of age.

This change will put infants at higher risk for severe disease. The hepatitis B vaccine birth dose and completion of the hepatitis B vaccine series in the first 18 months of life protect infants and children during a vulnerable time of their lives. No new data were presented on the safety or effectiveness of the hepatitis B vaccine to justify this recommendation change by the ACIP. In fact, the hepatitis B vaccine has one of the most well-established safety records of any vaccine. RIDOH's position aligns with the American Academy of Pediatrics' Recommended Child and Adolescent Immunization Schedule and the Northeast Public Health Collaborative.

"The hepatitis B vaccine birth dose helps prevent a lifelong, potentially fatal, chronic infection, which can lead to serious liver disease and liver cancer later in life. The hepatitis B vaccine has been tested extensively for safety, and we know that it works. Since 1991, when we started recommending it for all newborns, infections with hepatitis B virus in children and teens have decreased by 99%," said Director of Health Jerry Larkin, MD. "No matter what is happening at the federal level, in Rhode Island, vaccine policy will continue to be grounded in science, data, and facts."

RIDOH has issued advisories to healthcare professionals and birthing hospitals reiterating the importance of administering hepatitis B vaccine to all newborns at birth and the full vaccination series in accordance with the American Academy of Pediatrics' recommendations.

"For more than 3 decades, we in public health and pediatrics have recognized the importance of newborn hepatitis B vaccination. The Rhode Island Chapter of the American Academy of Pediatrics strongly endorses this continued practice," said Dr. Scott Rivkees, President of the Rhode Island Chapter of the American Academy of Pediatrics. "We thank the Rhode Island Department of Health for its continued efforts in keeping our children safe and healthy."

"I strongly support the Rhode Island Department of Health's choice to continue recommending universal Hepatitis B vaccination for all infants," said Dr. Michael Koster, Vice President of the Rhode Island Chapter of the American Academy of Pediatrics. "The birth dose is a simple, effective way to protect newborns from a serious infection and promote lifelong health. Ensuring vaccine access at birth helps every baby, no matter their background, have the same opportunity to start life healthy. Strengthening access keeps our communities safe, resilient, and thriving."

"The Northeast Public Health Collaborative reaffirms our hepatitis B recommendations for infants and children and confirms the Advisory Committee on Immunization Practices' (ACIP) votes do not change vaccination practices within our member jurisdictions. The Collaborative continues to recommend that all newborns receive a hepatitis B vaccine birth dose within 24 hours of delivery. Newborns born to birth parents who test positive for hepatitis B infection or have an unknown status should still receive the vaccine within 12 hours of birth. Additionally, all children should still complete the full vaccination series within 18 months. The Collaborative does not recommend use of a serology test to determine whether the full vaccine series should be given since there are no data to support that serology is a good indicator of lifelong protection after one dose. These recommendations align with the American Academy of Pediatrics' Recommended Child and Adolescent Immunization Schedule and reflect a previously released scientific consensus statement from the Northeast Public Health Collaborative. As always, we encourage individuals to consult with qualified healthcare professionals and rely on trusted medical sources when making decisions about their health or the health of their children. We also urge caution in sharing or acting on unverified health claims. The Northeast Public Health Collaborative is a voluntary coalition of public health agencies working together to share expertise, improve coordination, enhance capacity, strengthen regional readiness, and protect evidence-based public health in our jurisdictions."

The Northeast Public Health Collaborative is a coalition of public health agencies working together to share expertise, improve coordination, enhance capacity, strengthen regional readiness, and protect evidence-based public health. The group's shared goal is to protect the health, safety, and well-being of our populations by providing information based on science, data, and evidence, while working to ensure equitable access to vaccines, medications, and services.