Live updates: CDC advisers to vote on hepatitis B vaccine practice, discuss childhood immunization schedule
Friday’s meeting of the CDC’s outside vaccine advisers includes a scheduled presentation comparing the US vaccination schedule to that of Denmark.
It’s set to be delivered by the US Food and Drug Administration’s Dr. Tracy Beth Hoeg, who said of a planned vote to remove a universal newborn dose recommendation for the hepatitis B vaccine: “I think this is a very positive … vote, one that brings us in line with peer nations to not recommend giving the hepatitis B vaccine routinely at birth.”
Dr. Adam Langer, the CDC’s hepatitis B expert, who’s worked for the public health agency for almost 20 years, took issue with the comparison Friday morning.
“The United States is a unique country,” Langer began. Of Denmark, he pointed out, “the entire country has 6 million people. The population of New York City alone is 8 million people.”
Other differences cited by Langer:
• More than 95% of pregnant women in Denmark are screened for hepatitis B, “far higher than the number in the United States.”
• Prenatal care in Denmark is free “for both citizens and refugee or asylum seekers in Denmark. We all know this is not the case in the United States.”
• Denmark has a national health registry that compiles health information at the individual level; “the US does not have that, and I imagine that our privacy culture would not permit us to ever have something like that.”
• In Denmark, pregnant women who test positive for hepatitis B virus are followed up with, along with all infants, to ensure they’re vaccinated and tested for the virus, whereas in the US, “many of these infants are 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.
The best comparison, he said, might be Canada, where right now recommendations for hepatitis B vaccination are developed at the local level. But, Langer said, “recent studies in Canada have shown that a universal hepatitis B birth dose is going to be needed to achieve elimination” of the virus in Canada, “which is exactly what we learned here in the United States decades ago.”
“Let’s talk about apples to apples, not apples to oranges,” Langer said.
Hoeg responded that the level of risk for babies isn’t different because of differences in health-care systems.
