Dr. Tracy Beth Hoag

The U.S.

is an outlier in recommending a universal birth dose of the hepatitis B vaccine compared to other high-income nations.

And the data that we used to approve the hepatitis B vaccines for infants were based on studies that had very short-term follow-up and no control group.

There was not even a control group.

It was just an observational study.

We would never approve a vaccine based on data like those today.

So we are working with very

low-level evidence here, and we have very limited confidence in what we say when we say these vaccines are safe.

And so, you know, we have established that it does cause anaphylaxis, rarely fever, reactogenicity.

And so I think that I agree with Retsef that we need to be humble when we're saying that we have the evidence that the benefits outweigh the harms here of giving this vaccine.

And again, I think that there's a reason that peer nations to the United States do not

recommend this vaccine routinely at birth.