A debate over the US policy of universal hepatitis B vaccination for newborns took center stage at a meeting of the CDC’s vaccine advisory committee on Friday.
The discussion was sparked by a scheduled presentation from the FDA’s Dr. Tracy Beth Hoeg, who compared the US vaccination schedule to that of Denmark. Dr. Hoeg supported a potential vote to remove the universal newborn dose recommendation, calling it a “very positive … vote, one that brings us in line with peer nations.”
However, the comparison was sharply criticized by Dr. Adam Langer, a CDC hepatitis B expert with nearly two decades of experience. “The United States is a unique country,” Langer began, arguing that Denmark, with a population of 6 million, is smaller than New York City alone.
Langer highlighted several critical differences between the two nations’ healthcare systems. He noted that in Denmark, over 95% of pregnant women are screened for hepatitis B, prenatal care is free for all, and a national health registry ensures comprehensive follow-up for mothers and infants. In contrast, he said the US has lower screening rates, disparate access to care, and no national registry, resulting in many at-risk infants being “lost to follow-up as soon as they leave the hospital.”
“Denmark and, for that matter, virtually all other high-income countries are not really peer nations,” Langer concluded. He suggested Canada is a more apt comparison, pointing out that recent Canadian studies indicate a universal birth dose is necessary to eliminate the virus—a conclusion the US reached decades ago.
“Let’s talk about apples to apples, not apples to oranges,” Langer urged.
In response, Dr. Hoeg countered that differences in healthcare systems do not alter the fundamental level of risk for infants.
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