Thoughts before the next ACIP meeting

Note: this post was written prior to today’s meeting but it failed to post, so some of this will seem a bit outdated, but given some of the discussion, still quite relevant.

It is quite interesting to watch the onslaught of articles in anticipation of the upcoming ACIP meeting. The agenda is public, and not incredibly detailed, so it is curious how some media outlets are running with stories that have no basis. A suggestion to readers: If a communications person from HHS and/or the new chair of the ACIP committee, Dr. Kirk Milhoan, are not quoted, then it is probably a propaganda piece.

HepB is the one clear thing on the agenda. Again, lots of media articles all of a sudden about how “safe and effective it is”. So here I have some questions for you to consider.

First, ACIP voted in September that all mothers should be HepB tested. The lack of information on pregnant and delivering mothers on their HepB status is the justification for universal vaccination. Yes, children born to infected moms are at incredibly high risk of HepB infection, but children born to HepB negative moms? Much much lower risk. Also, if you paid attention in September, the CDC did not have great data on the actual risk to children born to HepB negative moms.

Second, for the “safe and effective”, “why are we making changes” crowd: (Who are of course predicting what they think the changes might be), some questions for you:

• Do you take medications for conditions that you don’t have? There are an awful lot of things advertised on TV – do you go out and get them all?

• Do you take preventative medications for infections that are spread through blood, like HIV, even if you are low risk?

• What about the vaccines that are given in other countries around the world that are not given in the US because of the low risk profile (think about things you get when you travel like yellow fever, tuberculosis is given in other countries but not the US, etc). Should you take those too? Why do you suppose those are not on the CDC recommended list?

• How do you know that the vaccines are “safe” – have you yourself looked at the data?

• Have you considered that not all countries have a universal birth dose of HepB – why do you suppose that is?

• HepB is not Hepatitis C. (Just putting that out there, some public commenters had that confused in September.)