Taiwan to continue universal hepatitis B vaccination for newborns

Taipei, Dec. 6 (CNA) Taiwan will not follow the United States' controversial decision to end universal hepatitis B vaccinations for newborns, as over half of the country's infections are mother-to-child transmission, Taiwan Centers for Disease Control (CDC) said Saturday.

The decision followed CDC consultations with experts from the Advisory Committee on Immunization Practices (ACIP), the office said.

ACIP experts recommended maintaining the vaccination policy, in place since July 1986, to further reduce hepatitis B prevalence, CDC spokesperson Lin Ming-cheng (林明誠) told reporters.

Under the policy, newborns receive three doses of the hepatitis B vaccine (HBV) -- at birth, one month, and at six months -- to prevent infections that could lead to cirrhosis or liver cancer if left untreated.

The Taiwan CDC said the country's high infant vaccination rate has helped cut the hepatitis B carrier rate among children aged six and under to 0.8 percent, down from 10.5 percent before 1986.

Last year, vaccination rates among newborns for the three doses were 93.1 percent, 98.9 percent, and 97.9 percent, respectively, it added.

Lin said the policy was introduced because over half of hepatitis B infections are transmitted from mother to child, adding that infection rates remain high among people born before July 1986.

The U.S. Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices on Friday voted to end universal recommendations for hepatitis B vaccinations, instead recommending that decisions be made on an individual basis.

According to the CDC website, the vote was driven by a study showing that the universal birth dose had only a small impact on the decline in acute hepatitis B cases compared with improvements in blood screening, dialysis practices, and needle exchange programs.

It also said only 0.5 percent of pregnant women in the U.S. test positive for hepatitis B.

The decision, however, has been derided by professionals in the field.

Michael Osterholm, a public health expert at the University of Minnesota was quoted by the New York Times as saying following the decision: "Today is a defining moment for our country ... We can no longer trust federal health authorities when it comes to vaccines."

Critics of the decision, including within the CDC committee, said there was no evidence that the vaccine was not safe and plenty of evidence that it has been effective.

"Infant immunization has been directly linked to a 99 percent decline in acute hepatitis B cases in children, adolescents and young adults between 1990 and 2019," the Guardian wrote, citing a 2023 study in Public Health Reports, the official journal of the Office of the U.S. Surgeon General.

In Taiwan, two medical experts backed the Taiwan CDC's decision, citing the vaccine's effectiveness in protecting public health.

The U.S. may have adjusted its policy due to lower hepatitis B prevalence and cost-effectiveness considerations, but the situation in Taiwan is completely different, said Huang Chien-hsien (黃建賢), a physician at the Shin Kong Wu Ho-Su Memorial Hospital.

Newborns can be infected during birth through contact with their mother's bodily fluids, and giving the vaccine two months later would no longer prevent mother-to-child transmission, said Lee Ping-ing (李秉穎), a physician and convener of Taiwan's ACIP.

Although the immune response in newborns is slightly weaker, studies have shown that the vaccine still provides over 90 percent protection, proving the policy effective, Lee said.