The United States has abruptly overturned a three-decade-old public health policy, ending its recommendation for all newborns to receive the hepatitis B vaccine at birth. The decision, confirmed Tuesday, marks a significant departure from established medical guidance in place since 1991.

This policy shift, driven by a new advisory panel appointed by Health Secretary Robert F. Kennedy Jr., directly challenges the global medical consensus and puts a spotlight on Kenya’s own immunization program. For millions of Kenyan families, the routine childhood vaccination schedule is a cornerstone of public health, and this divergence by a global leader raises pressing questions about the future of disease prevention.

A Departure From Global Norms

The US Centers for Disease Control and Prevention (CDC) will now advise parents of infants born to hepatitis B-negative mothers to consult with healthcare providers on whether to administer the vaccine. Acting CDC Director Jim O’Neill stated the move was about “restoring the balance of informed consent to parents whose newborns face little risk of contracting hepatitis B.” This new "individual-based decision-making" approach has been met with concern from medical experts who warn it could expose more children to the virus.

The decision stands in stark contrast to long-standing international health policy. The World Health Organization (WHO) unequivocally recommends that all infants receive their first dose of the hepatitis B vaccine as soon as possible after birth, preferably within 24 hours. This practice is credited with dramatically reducing mother-to-child transmission, the most common route for chronic infections that can lead to liver cancer.

The View from Kenya

In Kenya, the hepatitis B vaccine is a critical component of the Kenya Expanded Programme on Immunization (KEPI). While a standalone birth dose is not standard in the public schedule, the vaccine is administered as part of the pentavalent shot at 6, 10, and 14 weeks. Some private hospitals, however, do offer a birth dose. This established strategy is vital in a country where the virus remains a significant public health concern.

Understanding the local context is key:

• Prevalence: Recent studies estimate the national prevalence of Hepatitis B in Kenya among adults is around 3.0%, translating to approximately 810,600 people aged 15-64 living with the infection.
• Global Standard: The WHO has promoted universal infant vaccination against Hepatitis B since 1992, a strategy that has proven highly effective worldwide.
• US Impact: The universal birth dose policy in the US led to a 99% decline in pediatric HBV infections since the early 1990s, a success story that experts now fear could be undermined.

The US policy change was initiated by an advisory committee whose members were appointed by Robert F. Kennedy Jr., a prominent anti-vaccine activist prior to becoming the nation's top health official. Analysts note this signals a significant reshaping of American immunization policy, moving away from universal public health mandates toward individual choice.

As the United States charts this new course, health officials in Kenya and across the globe will be watching closely. The outcome will weigh the long-held success of universal vaccination against a new emphasis on parental autonomy, a debate that could shape the health of the next generation.