U.S. Retreat on Hepatitis B Vaccine Leaves Global Health Experts Concerned, Ghana Battles for Access
The Centers for Disease Control and Prevention’s recent decision to remove the hepatitis B vaccine from its recommended schedule for all children has sparked international concern, as nations like Ghana race to secure the life-saving immunization amidst economic and logistical hurdles. While the U.S. steps back, citing questions about efficacy and a perceived outlier status in global immunization practices, other countries recognize the critical importance of protecting newborns from this perilous, liver-attacking virus.
the CDC’s shift, driven in part by Health Secretary Robert F. Kennedy Jr.’s long-held skepticism about vaccine safety – including unsubstantiated links to autism – has raised alarms among public health officials. according to a Department of Health and Human Services memo released last Friday, 20 peer nations, with the exceptions of Denmark and finland, continue to recommend the hepatitis B vaccine for all children, either at birth or later in life. This decision comes as the U.S. already faces over 1,800 deaths annually attributed to hepatitis B.
“It’s just really sad,” says Dr. Samuel So, a surgeon specializing in hepatitis B at Stanford Medicine, who treats patients with liver cancer caused by the virus. “This has done so much damage to the reputation of the CDC.” Experts predict a decline in vaccination rates as a direct result of the policy change.
Meanwhile, the situation in Ghana highlights the stark realities faced by many low-income countries. Nearly one in ten Ghanaians carries chronic hepatitis B, with approximately 10,000 new infections reported each year in the nation of 35 million. Since 2015, deaths from complications of the virus have risen, reaching 14,000 in 2022.The economic burden on patients and the healthcare system is substantial, as treatment remains largely out-of-pocket.
The virus’s ancient origins and efficient transmission patterns, particularly through mother-to-child transmission, make early intervention crucial. When infants in countries like Ghana miss the birth dose, the risk of lifelong infection skyrockets, ranging from 10% to 90% depending on the severity of the mother’s infection. Approximately 95% of infected infants become lifelong carriers, facing a “life-long stigma” and the threat of life-threatening liver disease.
Vaccination at birth offers a simple, cost-effective solution. A timely birth dose is roughly 75% to 95% effective, with follow-up doses strengthening protection. the second dose provides long-term protection to about two-thirds of those vaccinated. For years, advocates in Ghana have fought for worldwide access to the hepatitis B birth dose, viewing it as a basic right. “We must all hold hands and push hepatitis into the deep blue ocean.”
His efforts, along with those of advocacy groups, eventually led Gavi to agree to support hepatitis B birth doses in 2018, with implementation planned for 2021. However, the COVID-19 pandemic caused further delays. In 2024, Gavi announced it would help cover the cost of newborn vaccines, providing a framework for Ghana to co-purchase mass quantities.
Despite the announcement, the Ghanaian government’s official rollout was delayed, with a planned September launch failing to materialize. Though Charles Adjei, executive director of the hepatitis Alliance of Ghana, remains “sure” the campaign will launch in 2026, uncertainty persists. “It was very unpleasant, and at a point it was very irritating, especially when you have the figures and you’re showing how many people are dying as a result of a vaccine-preventable condition,” Adjei says.
Even in countries with established birth-dose programs, coverage rates remain low, with sub-Saharan African nations averaging only 17% coverage, according to a recent report. Adjei also expresses concern about the future of Gavi funding and the potential for the newborn hepatitis B vaccine to be deprioritized.
Despite the ongoing challenges, Adjei finds strength in a global community of hepatitis advocates. Dr. Nartey, who treats patients with hepatitis, envisions a Ghana free from the disease. “It’s a good feeling to see that you are doing something to try to reduce the burden of the largest cause of cancer mortality in your country,” she says. “I see their future when I see that they’ve been vaccinated. At least I know that they’re not going to die.”
