{"id":78385,"date":"2026-01-05T16:43:31","date_gmt":"2026-01-06T00:43:31","guid":{"rendered":"https:\/\/lapost.us\/?p=78385"},"modified":"2026-01-05T16:43:31","modified_gmt":"2026-01-06T00:43:31","slug":"a-rollback-at-birth-new-hepatitis-b-guidance-could-deepen-health-disparities","status":"publish","type":"post","link":"https:\/\/lapost.us\/?p=78385","title":{"rendered":"A Rollback at Birth: New Hepatitis B Guidance Could Deepen Health Disparities"},"content":{"rendered":"
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By<\/span>Sunita Sohrabji<\/a><\/div>\n<\/div>\n<\/div>\n
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Babies from East and South Asian American communities and African immigrants are most vulnerable to hepatitis B infections.<\/p>\n<\/div>\n<\/div>\n

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Minnie Zhou photo via Unsplash (copyright free)<\/figcaption><\/figure>\n<\/div>\n<\/div>\n
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For decades, U.S. public health policy has treated hepatitis B vaccination at birth as non-negotiable: every newborn, regardless of maternal risk factors, receives a first dose within 24 hours of life.<\/p>\n

The approach mirrors global guidance from the World Health Organization and has been credited with sharply reducing pediatric hepatitis B infections and future liver cancer risk.<\/p>\n

But new recommendations from the CDC\u2019s Advisory Committee on Immunization Practices (ACIP) have reopened the debate. On Dec. 5, ACIP issued revised\u00a0guidelines<\/a>, recommending that only infants born to Hep-B positive mothers should be immunized at birth. Hep-B negative mothers can now choose to vaccinate or not, according to new ACIP recommendations, which also cancelled out the mandatory three dose series. The Centers for Disease Control and Prevention approved the updated guidances Dec. 15.<\/p>\n

Pushback<\/h2>\n

In a Dec. 5\u00a0memo<\/a>, the American Association of Immunologists said it was disappointed by ACIP\u2019s recommendations. AAI noted that since implementation of vaccination at birth, chronic hepatitis B cases in children and adolescents have\u00a0fallen by 99%.<\/a><\/p>\n

The West Coast Health Alliance \u2014 comprised of the states of California, Hawaii, Oregon, and Washington also released a\u00a0statement<\/a>\u00a0Dec. 5, recommending that the hepatitis B vaccine series should be given to all newborns.<\/p>\n

ACIP Recommendations Not Evidence-Based<\/h2>\n
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Dr. Samuel So, founder and executive director of the Asian Liver Center at Stanford University. (Stanford Medicine photo)<\/figcaption><\/figure>\n<\/div>\n

Dr. Samuel So \u2014 founder and executive director of the Asian Liver Center at Stanford University \u2014 called the new ACIP recommendations \u201cshort-sighted and not evidence-based.\u201d In an interview with American Community Media, So stated that birth dose is not simply an infection-prevention tool, but a cancer-prevention strategy for infants.<\/p>\n

\u201cIf an adult contracts hepatitis B, only about 5% will go on to develop a chronic infection that could result in liver cancer or cirrhosis. However, if a newborn or young child becomes infected, the risk significantly increases. Between 50% to 90% of these infants will develop a chronic infection that can lead to serious liver disease and cancer.\u201d<\/p>\n

\u201dThis heightened risk is why organizations like the World Health Organization and the CDC have referred to the hepatitis B vaccine as the first anti-cancer vaccine,\u201d said So. \u201cRolling back immunizations at birth puts us on a path toward more liver cancer, more cirrhosis, and more preventable deaths.\u201d<\/p>\n

The stakes are highest for East Asian, South Asian, and African immigrant communities, where chronic hepatitis B remains endemic and is often acquired at birth or in early childhood.<\/p>\n

Below are excerpts of the interview with Dr. So.<\/p>\n

Dr. So, why are certain communities disproportionately impacted by hepatitis B?<\/strong><\/h4>\n

People born in East Asia, South Asia, and Africa have much higher rates of chronic hepatitis B because many were infected at birth or in early childhood \u2014 before vaccines were widely available. In those regions, between 4% and 12% of adults may be chronically infected. When those individuals immigrate to the U.S., they carry a much higher risk of liver cancer and cirrhosis.<\/p>\n

In the U.S., Asians are about nine times more likely to die from hepatitis B\u2013related liver disease. African Americans \u2014 many of whom trace ancestry to African countries with high prevalence \u2014 are two to three times more likely to die from hepatitis B complications.<\/p>\n

ACIP emphasizes maternal testing. Why isn\u2019t testing alone sufficient?<\/strong><\/h4>\n

Testing pregnant women has been recommended for over 20 years \u2014 this is not new. But it\u2019s not foolproof. Even among women with private insurance, about 15% are not tested during pregnancy. The numbers are likely much worse for women without stable prenatal care.<\/p>\n

More importantly, hepatitis B is extraordinarily infectious \u2014 50 to 100 times more infectious than HIV. A drop of blood can remain infectious on a surface for up to five days. Babies can be exposed through household contact, caregivers, or daycare environments. Testing alone does not address those risks.<\/p>\n

Can you explain environmental or \u201chorizontal\u201d transmission?<\/strong><\/h4>\n

Babies and young children can be infected through minor skin breaks \u2014 scratches, abrasions \u2014 from contact with infected household members or other children. This used to be a major problem before universal vaccination.<\/p>\n

With universal birth-dose vaccination, children can safely interact without fear. Without it, we return to an era of testing, exclusion, and stigma \u2014 something many Asian countries experienced before vaccination programs were in place.<\/p>\n

Some policymakers argue hepatitis B is mainly spread through sex or drug use. How do you respond?<\/strong><\/h4>\n

That completely misses the point. The primary goal of hepatitis B vaccination is not to prevent adult behavior \u2014 it\u2019s to prevent lifelong infection acquired in infancy that leads to cancer decades later.<\/p>\n

Saying we should vaccinate teenagers once they\u2019re sexually active is nonsensical. By then, the cancer risk is far lower. We learned this lesson with HPV: framing vaccines around behavior reduces uptake. Framing them around cancer prevention saves lives.<\/p>\n

What impact could ACIP\u2019s recommendation have long-term?<\/strong><\/h4>\n

It will lead to more babies becoming infected \u2014 especially those born to mothers who weren\u2019t tested, tested late, or lacked prenatal care. Those infections won\u2019t show symptoms in childhood, but decades later we\u2019ll see more liver cancer and cirrhosis.<\/p>\n

This decision does nothing to improve public health. It dismantles one of the most successful childhood vaccination strategies we\u2019ve ever had.<\/p>\n

What do global examples tell us?<\/strong><\/h4>\n

China is the best example. Before universal newborn vaccination, 10% of children developed chronic hepatitis B by age one. Today, that number is under 0.3%. That success is recognized worldwide as a major public-health achievement.<\/p>\n

I\u2019ve spent 20 years helping low-income countries improve birth-dose coverage. Now the U.S. risks sending the message that universal vaccination is optional \u2014 which could undermine global progress, especially in Africa, where most countries still struggle to implement birth-dose programs.<\/p>\n

Q: What is your advice to pregnant parents right now?<\/strong><\/h4>\n

Follow the gold-standard recommendation: every newborn should receive the hepatitis B vaccine within 24 hours of birth and complete the full series. Three shots within six months protect for life \u2014 against infection, liver cancer, and stigma.<\/p>\n

This is one of the safest, most effective vaccines we have. As a surgeon who treats liver cancer, I can tell you: prevention is everything.<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

BySunita Sohrabji Jan 2, 2026 Babies...<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16,9,7],"tags":[],"class_list":["post-78385","post","type-post","status-publish","format-standard","hentry","category-health","category-opinion","category-u-s-a"],"_links":{"self":[{"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts\/78385","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=78385"}],"version-history":[{"count":1,"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts\/78385\/revisions"}],"predecessor-version":[{"id":78386,"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts\/78385\/revisions\/78386"}],"wp:attachment":[{"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=78385"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=78385"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=78385"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}