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In the past few months, the U.S. Centers for Disease Control and Prevention has changed their guidance on universally recommending the hepatitis B vaccine for all newborns. The updated guidelines, approved based on recommendations by the CDC Advisory Committee on Immunization Practices, advise women testing negative for the virus at the time of giving birth to consult their healthcare providers to see if their babies should get their first doses within 24 hours of birth.

For infants not receiving the vaccine at birth, the CDC suggests an initial dose be given "no earlier than two months of age."

This represents a significant departure from decades' of precedent. The universal recommendation had not been reviewed in more than seven years in the U.S., and it's not clear how widely these recommendations will be followed.

The general idea behind the new recommendations is that unless a child is born into a household where a person infected with hepatitis B is present, or where a household resident is in frequent contact with someone who recently emigrated from a country where hepatitis B is prevalent, a child should not needlessly be exposed to a vaccine.

Critics of this new policy, like the American Academy of Pediatrics, worry that this approach will likely cause a rise in hepatitis B infections due to virus spread.

In light of this development, I wanted to look at how the U.S. stacks up against other so-called developed nations in terms of ensuring newborns receive the hepatitis B vaccine. In a later blog post, I may subsequently examine where this change is likely to take us as a country.

More than anything, this blog post is meant as a baseline that we'll use going forward to track how much these recommendations take hold. I want to say thanks to Kaggle user Daria Chemkaeva for pointing me to the World Health Organization's data related to hepatitis B immunization coverage among 1-year-olds, which will inform a significant portion of this post.

Although the U.S. isn't currently at the forefront of administering the hepatitis B vaccine to newborns among peer nations, it's also not at the bottom of the pack. If we look at a representative sample of these nations, this is plain to see.

Of course, the term "peer nations" can mean different things to different people, and there are all sorts of metrics for determining the most advanced economies. My favored approach is to include the countries in the Organisation for Economic Co-operation and Development (OECD). Your mileage may vary with this, and I acknowledge that there are many alternate, equally valid measures that include different countries.

At any rate, if we look just at the OECD countries, we'll see that, according to World Health Organization (WHO) data, the U.S. is in the middle of the pack in terms of administering hepatitis B vaccines to newborns across a range of years. This data isn't as accurate as it could be because certain countries (Denmark, Hungary, and Iceland) don't make their data available to the WHO. In any case, it gives us a rough idea of how the U.S. compares to like countries. The data below is for the year 2024.

Data courtesy of the WHO

Next, let's look at how each U.S. state matches up against each other, and the percentage change over the years. This data comes from the Centers for Disease Control and Prevention (CDC) and is incomplete when it comes to certain states. Also, it covers hepatitis B rates across all ages, not just newborns.

Despite this, it's a good look at the trajectory states have been on between 2020 and 2023 in terms of overall infection rates. Since one of the main concerns with the new guidance is that infection rates will increase, this is valuable information to track over time.

Data courtesy of the CDC