US vaccine shift puts pressure on Australia’s childhood immunisation program

The United States’ decision to pull hepatitis B vaccination back from its routine childhood schedule has opened a new front in the global vaccination debate. Experts are confronting the prospect that an international policy shift could undermine trust in Australia’s own immunisation program.

Hepatitis Australia has stressed that Australia’s recommendations have not changed following moves by the US Administration to remove hepatitis B vaccination from the group of vaccines routinely recommended for all children and instead shift it towards ‘individual risk’ or ‘shared clinical decision-making’, as reported in Health Industry Hub.

The US changes removes hepatitis B vaccination from the group of vaccines routinely recommended for all children, instead shifting it towards recommendations based on ‘individual risk’ or ‘shared clinical decision-making’. The move threatens to add further uncertainty to childhood vaccination at a time when Australia is already confronting declining vaccination rates since the COVID-19 pandemic.

Hepatitis Australia CEO Lucy Clynes said Australians should retain confidence in the evidence underpinning the national vaccination program.

“Chronic hepatitis B and hepatitis C are leading causes of liver disease and liver cancer, and without appropriate medical care, up to one in four people living with chronic hepatitis B can die from its complications,” said Clynes.

Seven hepatitis B vaccines from GSK, Sanofi and MSD are approved for use in Australia, with three included on the National Immunisation Program (NIP): Engerix-B, Infanrix hexa and Vaxelis.

“Vaccination remains Australia’s best defence and the professional medical advice has not changed. Our infectious diseases and immunisation experts continue to strongly support hepatitis B vaccination, including vaccination at birth,” explaninrf Clynes. “Parents can be fully confident that the advice they receive in Australia is based on decades of medical evidence showing that the hepatitis B vaccine is safe, effective and protects children against a virus that can cause serious lifelong liver disease and liver cancer.”

The timing is particularly significant. Australia is working towards eliminating hepatitis B and hepatitis C as public health threats by 2030, and any erosion in trust around vaccination risks putting another obstacle in the path towards that target.

“Routine childhood vaccination has helped drive a staggering 60% reduction in hepatitis B cases among young Australians,” Clynes said. “The birth dose has been part of Australia’s vaccination program for more than 25 years, babies tolerate it very well and Australian parents have overwhelmingly embraced vaccination as a simple and effective way of protecting their children. This is a public health success story we should be proud of and continue to build upon.”

Hepatitis Australia President and infectious diseases physician Professor Joseph Doyle said there was no corresponding shift in Australian policy, with national recommendations continuing to be supported by extensive clinical evidence.

“The hepatitis B vaccination is a safe and highly effective way of preventing infection and the serious liver disease that can follow,” emphasised Professor Doyle. “The birth dose is particularly important because hepatitis B can be transmitted from mother to child during birth. If a baby becomes infected with hepatitis B at or around birth, there is around a 90% chance that the infection will become lifelong.”

That risk makes the birth dose a critical intervention because if a baby becomes infected with hepatitis B at or around birth, there is around a 90% chance that the infection will become lifelong.

“Vaccination has played an enormous role in reducing hepatitis B transmission in Australia and remains absolutely fundamental to our efforts to eventually eliminate hepatitis B as a public health threat,” Professor Doyle reiterated. “Our advice to parents is that Australia’s recommendations have not changed. Speak to your GP, nurse or other healthcare professional and continue to follow the Australian vaccination schedule.”

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