A federal vaccine committee has recommended ending the decades-long guidance that all newborns be immunized at birth against hepatitis B, the highly infectious virus that can lead to chronic liver disease in infected children.
The controversial change, decided in an 8-to-3 vote on Friday, was advanced by outspoken vaccine skeptic Robert F. Kennedy Jr.'s handpicked Advisory Committee on Immunization Practices.
Kennedy, who heads President Donald Trump's Health and Human Services Department, has argued that because hepatitis B is primarily transmitted during sex, the vaccine is unnecessary for babies unless their mothers are infected. The panel recommended instead that parents consult with their doctors.
New York City's top health official, Acting Health Commissioner Dr. Michelle Morse discussed the change with All Things Considered host Sean Carlson.
The following transcript has been lightly edited for length and clarity.
Sean Carlson: Doctor, welcome back to the show. Can we just start with what hepatitis B is?
Dr. Michelle Morse: Great place to start. Hepatitis B is one of those very sticky viruses. I think most people know you can get it from blood – touching and coming in contact with blood of someone who has the virus. But hepatitis B, it's kind of unique in that you can also get it from touching surfaces that have the virus on it, or fluids of someone who's infected. That includes something simple like sharing a toothbrush or even a washcloth. It's incredibly infectious and it's very common. In fact, that's why we're so lucky to have a vaccine for it.
Well, what exactly has changed with this new guidance and what should parents in New York make of the guidance?
What's really sad to me is that these institutions – the Centers for Disease Control and Prevention and the Advisory Committee on Immunization Practices – are institutions that are globally renowned for following science and being at the vanguard of public health practice and data. And, sadly, this decision is a representation of how far those institutions have fallen from their mission. I'm really concerned because one of the biggest impacts of the vote is confusion. Parents are going to be confused about what they should do, and that's part of the reason I'm so glad I'm here with you to talk about what this really means. In fact, the reality is that in New York City and New York state, the guidance has not changed. We continue to uphold the best practices and our guidance and recommendation is still that all of our babies get that dose of the hepatitis B vaccine within 12 or 24 hours, depending on the case, of being born. And that has not changed. We do not plan to change it. And again, I'm extremely disappointed in the CDC and ACIP for this recommendation.
As you say, nothing has changed here in New York, but we do have that shift in federal guidance. What do you see as the consequences of those decisions here in New York?
Unfortunately, I do think the confusion and misinformation from this vote is going to have ripple effects. I also think that every New Yorker should care about this a lot because half of the people who have hepatitis B actually don't know they have it. And that is part of the reason this dose of this vaccine and the three-part series of the vaccine has been so lifesaving. In fact, the practice of giving the birth dose and all three doses by the age of 18 months has been in place for over 30 years. And childhood rates of hepatitis B, viral infection, have gone down by 99%. So again, I want to make sure New Yorkers know that the data on safety of this vaccine is very, very clear: It is safe. There was no new data presented by the vaccine committee to suggest in any way that we should change our practice.
And then I think the other consequence, frankly, is that for our providers, nurses, doctors, they're doing incredibly challenging work on the front lines. I am a practicing physician as well, and the extra work, confusion, etc., that comes from this kind of announcement and vote is really a distraction and there's a big opportunity cost.
Since President Trump took office this is not the first time that you've come on our air, on this show in particular, to push back hard on new federal guidance and regulations. Who is winning the information war, so to speak?
Yeah. Well, I think the beautiful thing about public health is that it's local and I'm very lucky to get to be the city's doctor and lead the oldest local health department in the country. It's also the largest. We just celebrated our 220th birthday. We have 7,000 health workers who are out there every day, talking to New Yorkers on the front lines, building policies, building data systems, really engaging with all of you. The fact that we have these agents, this agency, to do that work every day is priceless. And I'll just say that many of my colleagues who are health commissioners all across the country do not have what we have in New York City. And the fact that public health is local means that when the federal government does irresponsible things like this that cause confusion and, frankly, are deadly, we here in New York City can step up and make sure that we fill the void.
Have you noticed any parents in New York City shying away from vaccines?
I will acknowledge that, particularly since the pandemic, when the COVID vaccine did become quite controversial – it was far more controversial in other places around the country. But even here in New York City, we certainly got pushback about the requirements around the COVID vaccine at the height of the emergency phase of the pandemic. We are still challenged by some of the residual feelings or thoughts or reflections from New Yorkers on that. However, when we look at our vaccination rates when kids are heading into kindergarten, they are still extremely high. In fact, upward of 98% of our kids when they enter kindergarten have all the vaccines they need. But there are lots of confusing and, frankly, false messages on TikTok about vaccines, and sometimes people do listen to those. My advice is that you should talk to your doctor or your nurse about any questions you have about vaccines. Vaccine questions are normal. In fact, you should be asking questions about vaccines, and I also feel confident that your nurse or doctor will share really, really helpful information with you about which vaccines are best for you and answer any questions you might have about safety.
The Centers for Disease Control and Prevention has long been regarded as a gold standard for vaccine guidance. Do you still trust the CDC?
This is really the trillion-dollar question – a question that has an impact on the lives of so many people. At this point, I will be very honest and say that the leadership of the CDC and the leadership by Secretary Kennedy is extremely concerning. The areas where they have decision-making authority are compromised and no longer reliable. There are still spots of hope within the CDC as an institution, but overall, I can no longer direct New Yorkers to the CDC websites or resources as a best source of information. I can, however, direct them to the New York City Health Department's Instagram, social media, and our website, where you can still find reliable information.
Doctor, as always, thanks so much for coming on.
Thanks for having me.
