MILES PARKS, HOST:

The top vaccine advisory committee for the federal government voted yesterday to change its recommendation for the hepatitis B vaccine. This is a historic change from the current recommendation, which has been in place for decades, for newborns to receive three shots, including one at birth. The new recommendation will be for the hepatitis B vaccine only to be given at birth to infants born to women who test positive for the virus or whose infection status is unknown. This comes after a heated debate on Thursday that delayed the vote. The hepatitis B virus attacks the liver, and it has no cure. It can be especially serious for people who get infected as infants. The Hepatitis B Foundation released a statement on Thursday describing the meetings as lacking in transparency and one-sided. And we have the foundation's president, Dr. Chari Cohen, with us now. Thanks for being here.

CHARI COHEN: Hi. Thanks for having me today.

PARKS: So I really just want to start with this latest vote. What do you make of the committee's decision?

COHEN: I don't understand the committee's decision. There's no new evidence or no new data to suggest any changes to the universal hepatis B vaccine recommendation. There's certainly no evidence to consider going down from a three-dose vaccine recommendation to potentially a one-dose vaccine.

PARKS: So let's walk through a little bit of the committee's recommendations here. They're voting to recommend testing children's antibody levels after each hepatitis B vaccine shot to determine whether additional doses are needed. Is it possible that one or two doses will do the trick and that maybe the three aren't necessary?

COHEN: No. We have very strong data coming out of Alaska and clinical trials in other countries as well that checking titers is not a useful indicator of long-term protection, so there's really no utility there. What we do know is that all three doses are needed for long-term immunity. After the first dose, about 25% of healthy infants will develop immunity, and that percentage goes up to about 95- to 97% after the third dose. But I just want to restate that the third dose is needed for long-term lifelong protection.

PARKS: Talk to me a little bit about what we know about how the vaccine has impacted hepatitis B broadly since it's been in existence.

COHEN: The hepatitis B vaccine is instrumental in decreasing the cases of hepatitis B that we have seen both in the U.S. and globally. In the last 40 years, we have been giving universal hepatitis B vaccine to every baby born in the U.S., and we have seen a 99% decrease in infections among infants and children in the U.S. And to me, that's one of the biggest wins in modern public health history.

PARKS: What other outcomes, I guess, are you expecting from this decision beyond potential infection risk if less babies are vaccinated? Are there other costs specifically or consequences that could come from this decision?

COHEN: There was a modeling study done that just was published last week, I think, that shows how many new infections that this would lead to. And we know that delaying the birth dose to two months will lead to at least a few thousand new infections a year, a few hundred cases - at least 500 cases - of liver cancer a year and an annual health care cost of an additional $222 million a year.

PARKS: In your view, Dr. Cohen, are there aspects of the way the United States gives guidance about vaccines that do need reform, or is this really just skepticism for skepticism's sake?

COHEN: I think that it's important to continue to always do scientifically rigorous review of recommendations. And I want to state that for the past number of years, ACIP and CDC have done that. We do actually re-review recommendations when it's necessary. Right now, we have a situation where changes were made for what we can only see is no established scientific or clinical basis. So I certainly think it's going to have implications for hepatitis B coverage for the next generation.

PARKS: What do you tell, like, family and friends if they ask you, you know, I'm a little confused about this guidance, should I give my newborn the hepatitis B vaccine?

COHEN: I would say, I'm glad they asked, and I think it's important for every parent to know what is going in their kids' bodies. I asked. I had a little girl in the hospital 23 years ago, and I was working in the hepatitis B space, and I asked questions about the safety and efficacy of the vaccine. So I'm glad they're asking, and I would say, go to trusted sources of information. And right now, for me, I would go to the American Academy of Pediatrics. I would go to the CHOP Vaccine Education Center. I would go to the Hepatitis B Foundation and talk to your provider and make sure your provider is also using the most scientifically rigorous trusted sources of information.

PARKS: That's Dr. Chari Cohen of the Hepatitis B Foundation. Thank you so much for joining us.

COHEN: Thank you. Transcript provided by NPR, Copyright NPR.

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