1 00:00:02,640 --> 00:00:04,960 Speaker 1: Welcome to Wellness on MASS. I'm doctor Nicole Saffire and 2 00:00:05,000 --> 00:00:07,240 Speaker 1: this is your weekly rundown. Now. I was waiting until 3 00:00:07,240 --> 00:00:09,440 Speaker 1: the very last minute to put this out because I 4 00:00:09,480 --> 00:00:12,760 Speaker 1: wanted to see if the CDC's ASIP was going to 5 00:00:12,800 --> 00:00:15,440 Speaker 1: hold a vote on whether or not to be giving 6 00:00:15,600 --> 00:00:20,200 Speaker 1: universal Hepatotis B vaccines to newborns. And to be honest, 7 00:00:20,200 --> 00:00:22,480 Speaker 1: they're just talking, talking, talking. A lot of the members 8 00:00:22,560 --> 00:00:25,479 Speaker 1: of this community love to hear themselves talk. So I 9 00:00:25,520 --> 00:00:27,640 Speaker 1: got to get this out to you. I will update 10 00:00:27,680 --> 00:00:30,159 Speaker 1: you on social media and next week what they end 11 00:00:30,280 --> 00:00:33,880 Speaker 1: up voting on. But here's what's happening this week. Yesterday 12 00:00:33,960 --> 00:00:38,599 Speaker 1: today ASIP, the Advisory Committee on Immunization Practices through the CDC, 13 00:00:39,240 --> 00:00:42,600 Speaker 1: have been meeting to reconsider the long standing recommendation that 14 00:00:42,680 --> 00:00:46,280 Speaker 1: all newborns receive a birth dose of the hepatitis B vaccine. 15 00:00:46,320 --> 00:00:48,920 Speaker 1: And I'll be honest, the meeting has been messy, lots 16 00:00:48,920 --> 00:00:52,319 Speaker 1: of tension, coming down to one question. Do we need 17 00:00:52,360 --> 00:00:57,480 Speaker 1: to universally vaccinate at birth, especially in mothers who are 18 00:00:57,480 --> 00:01:01,160 Speaker 1: testing negative. That's a really good question. So mind you, 19 00:01:01,280 --> 00:01:04,360 Speaker 1: this proposal is not about infants born to mothers who 20 00:01:04,400 --> 00:01:08,080 Speaker 1: are positive for hepatitis B or who are unknown. Those 21 00:01:08,160 --> 00:01:12,040 Speaker 1: infants would still absolutely receive the birth dose they should. 22 00:01:12,680 --> 00:01:15,600 Speaker 1: Now the vote under consideration is really just for babies 23 00:01:15,840 --> 00:01:20,039 Speaker 1: whose mothers have a confirmed negative hepatitis B test. For 24 00:01:20,120 --> 00:01:23,560 Speaker 1: those infants, ASIP is weighing whether to eliminate the universal 25 00:01:23,600 --> 00:01:26,120 Speaker 1: birth dose and instead allowed the first shot to be 26 00:01:26,160 --> 00:01:29,360 Speaker 1: given at two months of age because they're not worried 27 00:01:29,360 --> 00:01:33,919 Speaker 1: about the mother passing hepatitis B to the infant during birth. Now, 28 00:01:34,360 --> 00:01:37,160 Speaker 1: this dose at two months is just to protect them 29 00:01:37,280 --> 00:01:40,360 Speaker 1: for the future, because you can still get hepatitis B. 30 00:01:41,160 --> 00:01:46,640 Speaker 1: So here's the debate. The pro vaccine position saying, essentially, 31 00:01:46,720 --> 00:01:50,040 Speaker 1: there's decades of data a clear benefit. If you look 32 00:01:50,080 --> 00:01:53,720 Speaker 1: at hepatitis B infections the United States, they have gone 33 00:01:53,760 --> 00:01:56,800 Speaker 1: down over the decades since we've been doing the universal 34 00:01:57,480 --> 00:02:03,000 Speaker 1: newborn vaccine dose. Now those critics are pushing back saying, yes, 35 00:02:03,280 --> 00:02:06,720 Speaker 1: maybe the vaccine had some effect, but it's dishonest to 36 00:02:06,760 --> 00:02:10,280 Speaker 1: say that it is wholly responsible for the decline and 37 00:02:10,320 --> 00:02:13,680 Speaker 1: hepatitis BE cases. And you know what, they're right because 38 00:02:13,680 --> 00:02:16,720 Speaker 1: what else happened during this time. We have gotten much 39 00:02:16,720 --> 00:02:19,760 Speaker 1: better at straining blood when it comes to hepatitis B 40 00:02:19,919 --> 00:02:25,720 Speaker 1: cases that were happening because of blood transfusions, organ transplants, dialysis, 41 00:02:26,200 --> 00:02:28,240 Speaker 1: and also when it comes to those who were getting 42 00:02:28,280 --> 00:02:32,240 Speaker 1: hepatitis B from intravenous drug use. There's also now this 43 00:02:33,040 --> 00:02:36,639 Speaker 1: clean needle spaces all throughout the country. So there are 44 00:02:36,639 --> 00:02:39,600 Speaker 1: many variables that have contributed to the decline and hepatitis 45 00:02:39,639 --> 00:02:42,080 Speaker 1: B cases. You can't just say it is one hundred 46 00:02:42,080 --> 00:02:48,760 Speaker 1: percent from the newborn vaccine dose. That isn't being entirely honest. Now, 47 00:02:49,240 --> 00:02:52,240 Speaker 1: the pro vaccine people are saying there's decades of data 48 00:02:52,320 --> 00:02:55,440 Speaker 1: showing that this vaccine in the newborn is safe. Well, 49 00:02:55,480 --> 00:02:59,440 Speaker 1: those criticizing it, they're not necessarily coming up with data 50 00:02:59,440 --> 00:03:01,679 Speaker 1: showing it's not safe, but they are coming up with 51 00:03:01,760 --> 00:03:05,640 Speaker 1: hypotheses saying there it may be unsafe, and some of 52 00:03:05,639 --> 00:03:09,760 Speaker 1: the hypotheses are. One of the well documented risk factors 53 00:03:09,760 --> 00:03:16,280 Speaker 1: for vaccines is that people babies specifically get fevers after vaccines. Well, 54 00:03:16,320 --> 00:03:20,160 Speaker 1: if a newborn baby gets a fever, it's a whole process. 55 00:03:20,560 --> 00:03:24,680 Speaker 1: It is admission to the hospital, spinal tap, blood cultures, 56 00:03:24,760 --> 00:03:27,640 Speaker 1: it's a whole thing. Because fevers in a newborn is 57 00:03:27,680 --> 00:03:31,680 Speaker 1: really a medical emergency. So should we be giving newborn 58 00:03:31,720 --> 00:03:34,120 Speaker 1: babies a vaccine that has a potential to give them 59 00:03:34,120 --> 00:03:37,720 Speaker 1: a fever and result in this downstream effect, especially if 60 00:03:37,760 --> 00:03:41,800 Speaker 1: we know that that mother was negative. And my personal opinion, no, 61 00:03:41,920 --> 00:03:45,760 Speaker 1: probably not. I don't necessarily believe newborn babies if the 62 00:03:45,840 --> 00:03:49,800 Speaker 1: mother is documented negative hepatitis BE and they are not 63 00:03:49,920 --> 00:03:53,920 Speaker 1: living a high risk lifestyle for hepatitis B infection, I 64 00:03:53,960 --> 00:03:56,200 Speaker 1: don't think that the newborn baby needs to get that 65 00:03:56,240 --> 00:03:59,920 Speaker 1: shot before they leave the hospital. Now, should they begin 66 00:04:00,240 --> 00:04:03,120 Speaker 1: it at two months? Well, I'd love to see the 67 00:04:03,240 --> 00:04:06,760 Speaker 1: data to support that at two months it's beneficial. The 68 00:04:06,800 --> 00:04:09,000 Speaker 1: people who are saying let's go from newborn to two months, 69 00:04:09,040 --> 00:04:12,320 Speaker 1: they're not presenting any data showing benefits or risk of 70 00:04:12,400 --> 00:04:15,080 Speaker 1: doing it from newborn to two months. Is it going 71 00:04:15,160 --> 00:04:17,640 Speaker 1: to cause the same problems in a two month old? Maybe? 72 00:04:17,640 --> 00:04:20,640 Speaker 1: Maybe not. We don't necessarily worry the same amount about 73 00:04:20,640 --> 00:04:22,320 Speaker 1: fevers and a two month old as we do in 74 00:04:22,360 --> 00:04:26,160 Speaker 1: the newborn. But still, why two months? Why not six months? 75 00:04:26,240 --> 00:04:29,839 Speaker 1: Why not six years? Especially with waning immunity over time, 76 00:04:30,200 --> 00:04:33,240 Speaker 1: and we're more worried about kids getting hepatitis B the 77 00:04:33,279 --> 00:04:37,920 Speaker 1: older they get and the more lifestyle decisions they make. 78 00:04:37,960 --> 00:04:41,760 Speaker 1: That could expose them to it like unsafe sex practices, 79 00:04:42,200 --> 00:04:46,279 Speaker 1: IV drug use, working in healthcare where they could get pimpricks, 80 00:04:46,520 --> 00:04:49,920 Speaker 1: whatever it is. If we're talking about wanting to protect 81 00:04:49,920 --> 00:04:52,279 Speaker 1: them from hepatitis B as they get older, why would 82 00:04:52,360 --> 00:04:54,680 Speaker 1: we do it at two months. So I didn't really 83 00:04:54,760 --> 00:04:57,320 Speaker 1: like that recommendation because there was no data on it, 84 00:04:57,440 --> 00:05:00,000 Speaker 1: and I would like to open the conversation of even 85 00:05:00,040 --> 00:05:02,480 Speaker 1: giving it later in life, just like when you talk 86 00:05:02,520 --> 00:05:06,760 Speaker 1: about giving the HPV vaccine, we give that to teenagers 87 00:05:06,839 --> 00:05:12,400 Speaker 1: because you get human papillomavirus from sexual encounters. So why 88 00:05:12,440 --> 00:05:15,280 Speaker 1: not consider the hepatitis B vaccine around the same time. 89 00:05:15,400 --> 00:05:18,799 Speaker 1: So it is really risk base. That's my own personal 90 00:05:18,839 --> 00:05:22,320 Speaker 1: opinion there, So it's not really it's really talking about 91 00:05:22,360 --> 00:05:27,040 Speaker 1: timing here. Changing a long standing newborn recommendation without presenting 92 00:05:27,160 --> 00:05:31,719 Speaker 1: new evidence, it's not science. It's policymaking without data, and 93 00:05:31,839 --> 00:05:35,240 Speaker 1: that's what has so many clinicians raising an eyebrow and 94 00:05:35,279 --> 00:05:38,279 Speaker 1: getting worked up. Right now. People are saying, if you 95 00:05:38,400 --> 00:05:42,560 Speaker 1: change the universal newborn vaccine dose recommendation, babies aren't going 96 00:05:42,640 --> 00:05:46,000 Speaker 1: to have access to this vaccine. And the reality is, 97 00:05:46,279 --> 00:05:49,000 Speaker 1: I don't really think that's true. What is the mantra 98 00:05:49,120 --> 00:05:53,200 Speaker 1: of this current administration, this current CDC and ASIP is 99 00:05:53,760 --> 00:05:56,920 Speaker 1: putting the autonomy back with the patients, back with the clinicians. 100 00:05:57,120 --> 00:06:00,360 Speaker 1: So my guess what's going to come out of these 101 00:06:00,400 --> 00:06:02,919 Speaker 1: two days worth of meetings is they're going to say, 102 00:06:02,960 --> 00:06:07,279 Speaker 1: if the mother is documented Hepatitis BE negative, not living 103 00:06:07,320 --> 00:06:11,760 Speaker 1: a high risk lifestyle, IV drug user, and so forth, 104 00:06:12,200 --> 00:06:15,680 Speaker 1: then they're going to say, hold off on that newborn 105 00:06:16,080 --> 00:06:18,600 Speaker 1: vaccine dose, but if you want it, you can still 106 00:06:18,640 --> 00:06:21,240 Speaker 1: have it after a conversation with the doctor. You're always 107 00:06:21,279 --> 00:06:23,279 Speaker 1: going to give that little caveat there because they don't 108 00:06:23,279 --> 00:06:25,680 Speaker 1: want to take things away, but they also don't want 109 00:06:25,720 --> 00:06:28,359 Speaker 1: to mandate it. So it's going to say, have a 110 00:06:28,400 --> 00:06:30,960 Speaker 1: conversation with the doctor, they're still going to recommend that 111 00:06:31,000 --> 00:06:34,880 Speaker 1: newborn dose. In hepatitis BE positive moms or moms who 112 00:06:34,960 --> 00:06:38,080 Speaker 1: we don't have a known Hepatitis B status, But that 113 00:06:38,160 --> 00:06:41,320 Speaker 1: raises another question, why don't we know their status. We 114 00:06:41,400 --> 00:06:43,880 Speaker 1: need to make sure that all pregnant women are getting 115 00:06:44,000 --> 00:06:47,599 Speaker 1: the screening that they need, not just for Hepatitis B, 116 00:06:47,880 --> 00:06:51,960 Speaker 1: but for HIV and other communical diseases, because we have 117 00:06:52,040 --> 00:06:56,640 Speaker 1: to protect these babies. So I implore obgyns and mothers 118 00:06:56,680 --> 00:06:59,320 Speaker 1: out there, make sure you're getting tested when you are pregnant. 119 00:06:59,360 --> 00:07:02,479 Speaker 1: This texts your baby because if you have an infection, 120 00:07:03,080 --> 00:07:04,720 Speaker 1: we want to know ahead of time so we can 121 00:07:04,720 --> 00:07:07,720 Speaker 1: do everything we can to protect the baby. So we'll 122 00:07:07,720 --> 00:07:10,040 Speaker 1: see what comes out. I will fill you in next 123 00:07:10,040 --> 00:07:14,200 Speaker 1: week what they end up voting. The hepatitis B BIRTHDOS 124 00:07:14,320 --> 00:07:17,720 Speaker 1: remains one of the most effective and well steadied tools 125 00:07:17,760 --> 00:07:21,000 Speaker 1: in modern pediatrics. We know that it does reduce the 126 00:07:21,120 --> 00:07:25,560 Speaker 1: risk of infection, It absolutely does. Who needs it, when 127 00:07:25,600 --> 00:07:28,200 Speaker 1: they should take it. That's what's up for discussion here, 128 00:07:28,280 --> 00:07:31,440 Speaker 1: and I am happy to see this discussion happening. If 129 00:07:31,440 --> 00:07:34,840 Speaker 1: we want families to trust vaccine recommendations, then every change 130 00:07:34,920 --> 00:07:38,560 Speaker 1: must be backed by transparent, compelling evidence. The current ASIP 131 00:07:38,600 --> 00:07:41,080 Speaker 1: meeting is a lot of conjecture, a lot of people 132 00:07:41,160 --> 00:07:44,679 Speaker 1: just wanting to hear themselves speak, not really presenting any 133 00:07:44,840 --> 00:07:48,320 Speaker 1: new science. And that's what makes me a little bit uncomfortable. 134 00:07:48,560 --> 00:07:50,960 Speaker 1: But I am still very glad to see the conversation 135 00:07:51,080 --> 00:07:54,360 Speaker 1: being had. And that's it. I'm doctor Nicole Southfire. This 136 00:07:54,400 --> 00:07:57,880 Speaker 1: is Wellness Unmass in your weekly rundown, Listen to Wellness 137 00:07:57,920 --> 00:08:00,680 Speaker 1: unmuse on iHeartRadio wherever you get your part, and we 138 00:08:00,760 --> 00:08:01,680 Speaker 1: will see you next time.