Wellness Unmasked Weekly Rundown: Inside the CDC’s Review of Newborn Hepatitis B Vaccination

In this episode of Wellness Unmasked, Dr. Nicole Saphier breaks down the growing debate over universal hepatitis B vaccination for newborns. With the CDC’s ACIP committee reconsidering whether infants born to hepatitis B–negative mothers should receive the birth dose, Dr. Saphier examines the latest data, public-health implications, and potential policy shifts. She explores arguments on both sides, the importance of accurate maternal screening, and how changes to long-standing vaccine recommendations could impact parents, providers, and public trust. Wellness Unmasked is part of the Clay Travis & Buck Sexton Podcast Network - new episodes debut every Tuesday & Friday. 

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Episode Transcript

Speaker 1 (00:02):
Welcome to Wellness on MASS. I'm doctor Nicole Saffire and
this is your weekly rundown. Now. I was waiting until
the very last minute to put this out because I
wanted to see if the CDC's ASIP was going to
hold a vote on whether or not to be giving
universal Hepatotis B vaccines to newborns. And to be honest,
they're just talking, talking, talking. A lot of the members
of this community love to hear themselves talk. So I

(00:25):
got to get this out to you. I will update
you on social media and next week what they end
up voting on. But here's what's happening this week. Yesterday
today ASIP, the Advisory Committee on Immunization Practices through the CDC,
have been meeting to reconsider the long standing recommendation that
all newborns receive a birth dose of the hepatitis B vaccine.

(00:46):
And I'll be honest, the meeting has been messy, lots
of tension, coming down to one question. Do we need
to universally vaccinate at birth, especially in mothers who are
testing negative. That's a really good question. So mind you,
this proposal is not about infants born to mothers who
are positive for hepatitis B or who are unknown. Those

(01:08):
infants would still absolutely receive the birth dose they should.
Now the vote under consideration is really just for babies
whose mothers have a confirmed negative hepatitis B test. For
those infants, ASIP is weighing whether to eliminate the universal
birth dose and instead allowed the first shot to be
given at two months of age because they're not worried

(01:29):
about the mother passing hepatitis B to the infant during birth. Now,
this dose at two months is just to protect them
for the future, because you can still get hepatitis B.
So here's the debate. The pro vaccine position saying, essentially,
there's decades of data a clear benefit. If you look

(01:50):
at hepatitis B infections the United States, they have gone
down over the decades since we've been doing the universal
newborn vaccine dose. Now those critics are pushing back saying, yes,
maybe the vaccine had some effect, but it's dishonest to
say that it is wholly responsible for the decline and

(02:10):
hepatitis BE cases. And you know what, they're right because
what else happened during this time. We have gotten much
better at straining blood when it comes to hepatitis B
cases that were happening because of blood transfusions, organ transplants, dialysis,
and also when it comes to those who were getting
hepatitis B from intravenous drug use. There's also now this

(02:33):
clean needle spaces all throughout the country. So there are
many variables that have contributed to the decline and hepatitis
B cases. You can't just say it is one hundred
percent from the newborn vaccine dose. That isn't being entirely honest. Now,
the pro vaccine people are saying there's decades of data
showing that this vaccine in the newborn is safe. Well,

(02:55):
those criticizing it, they're not necessarily coming up with data
showing it's not safe, but they are coming up with
hypotheses saying there it may be unsafe, and some of
the hypotheses are. One of the well documented risk factors
for vaccines is that people babies specifically get fevers after vaccines. Well,

(03:16):
if a newborn baby gets a fever, it's a whole process.
It is admission to the hospital, spinal tap, blood cultures,
it's a whole thing. Because fevers in a newborn is
really a medical emergency. So should we be giving newborn
babies a vaccine that has a potential to give them
a fever and result in this downstream effect, especially if

(03:37):
we know that that mother was negative. And my personal opinion, no,
probably not. I don't necessarily believe newborn babies if the
mother is documented negative hepatitis BE and they are not
living a high risk lifestyle for hepatitis B infection, I
don't think that the newborn baby needs to get that
shot before they leave the hospital. Now, should they begin

(04:00):
it at two months? Well, I'd love to see the
data to support that at two months it's beneficial. The
people who are saying let's go from newborn to two months,
they're not presenting any data showing benefits or risk of
doing it from newborn to two months. Is it going
to cause the same problems in a two month old? Maybe?
Maybe not. We don't necessarily worry the same amount about

(04:20):
fevers and a two month old as we do in
the newborn. But still, why two months? Why not six months?
Why not six years? Especially with waning immunity over time,
and we're more worried about kids getting hepatitis B the
older they get and the more lifestyle decisions they make.
That could expose them to it like unsafe sex practices,

(04:42):
IV drug use, working in healthcare where they could get pimpricks,
whatever it is. If we're talking about wanting to protect
them from hepatitis B as they get older, why would
we do it at two months. So I didn't really
like that recommendation because there was no data on it,
and I would like to open the conversation of even
giving it later in life, just like when you talk

(05:02):
about giving the HPV vaccine, we give that to teenagers
because you get human papillomavirus from sexual encounters. So why
not consider the hepatitis B vaccine around the same time.
So it is really risk base. That's my own personal
opinion there, So it's not really it's really talking about
timing here. Changing a long standing newborn recommendation without presenting

(05:27):
new evidence, it's not science. It's policymaking without data, and
that's what has so many clinicians raising an eyebrow and
getting worked up. Right now. People are saying, if you
change the universal newborn vaccine dose recommendation, babies aren't going
to have access to this vaccine. And the reality is,
I don't really think that's true. What is the mantra

(05:49):
of this current administration, this current CDC and ASIP is
putting the autonomy back with the patients, back with the clinicians.
So my guess what's going to come out of these
two days worth of meetings is they're going to say,
if the mother is documented Hepatitis BE negative, not living
a high risk lifestyle, IV drug user, and so forth,

(06:12):
then they're going to say, hold off on that newborn
vaccine dose, but if you want it, you can still
have it after a conversation with the doctor. You're always
going to give that little caveat there because they don't
want to take things away, but they also don't want
to mandate it. So it's going to say, have a
conversation with the doctor, they're still going to recommend that
newborn dose. In hepatitis BE positive moms or moms who

(06:34):
we don't have a known Hepatitis B status, But that
raises another question, why don't we know their status. We
need to make sure that all pregnant women are getting
the screening that they need, not just for Hepatitis B,
but for HIV and other communical diseases, because we have
to protect these babies. So I implore obgyns and mothers

(06:56):
out there, make sure you're getting tested when you are pregnant.
This texts your baby because if you have an infection,
we want to know ahead of time so we can
do everything we can to protect the baby. So we'll
see what comes out. I will fill you in next
week what they end up voting. The hepatitis B BIRTHDOS
remains one of the most effective and well steadied tools

(07:17):
in modern pediatrics. We know that it does reduce the
risk of infection, It absolutely does. Who needs it, when
they should take it. That's what's up for discussion here,
and I am happy to see this discussion happening. If
we want families to trust vaccine recommendations, then every change
must be backed by transparent, compelling evidence. The current ASIP

(07:38):
meeting is a lot of conjecture, a lot of people
just wanting to hear themselves speak, not really presenting any
new science. And that's what makes me a little bit uncomfortable.
But I am still very glad to see the conversation
being had. And that's it. I'm doctor Nicole Southfire. This
is Wellness Unmass in your weekly rundown, Listen to Wellness
unmuse on iHeartRadio wherever you get your part, and we

(08:00):
will see you next time.