Non-experts

Non-experts whose research has been discredited presented on hepatitis B

From CNN's Brenda Goodman

In another departure from past practices, the CDC vaccine committee heard a presentation from Dr. Cynthia Nevison, a research associate at the University of Colorado at Boulder, where she is an atmospheric scientist.

One of her research studies, called “Autism Tsunami,” was written with the next ACIP presenter — Dr. Mark Blaxill, who introduced himself as a critic of the CDC who is now working at the agency — was retracted by the journal that published it.

The editors of the journal said the authors misrepresented and selectively cited. or cherrypicked, data and that there were no valid justifications for the mechanisms the authors proposed for prevention.

“This is someone with no hepatitis B expertise and a well documented anti-vaccine bias. They could not find an expert to present on this?” wrote Dr. Dorit Reiss, a law professor at the University of California at San Francisco and a vaccine policy expert who was posting about the meeting on social media.

In her presentation, Nevison, who introduced herself as a contractor to the CDC, suggested that hepatitis B infections had never been a real threat to infants.

Nevison’s presentation sought to cast doubt on the importance of the hepatitis B vaccine and on recent modeling evidence that indicated doing away with the birth dose would increase the number of preventable hepatitis B cases and deaths in kids.

“There’s very little evidence that horizontal transmission has ever been a significant threat to the average American child, and the risk probably has been overstated,” Nevison said.

Nevison noted that the greatest declines in hepatitis B cases had been among younger adults, ages 20 to 39 — exactly the age group born after the universal birth dose was first recommended in 1991.

Instead, she said the decline in cases in this age group “had to be [due to] other measures.” She said other measures that may have been driving down hepatitis B infections, including better screening of blood products used for transfusion, safer dialysis and the adoption of safer sex practices due to the AIDS epidemic.

In reality, the adoption of screening and recommendations to lower the risk of transmission to infants has been stepwise.

In 1984, the CDC first recommended vaccination of infants born to mothers who tested positive for hepatitis B. Four years later, in 1988, the CDC first recommended hepatitis B screening for all pregnant women. In 1991, the CDC recommended universal hepatitis B vaccination for infants, then, in 2005, the CDC updated the recommendation to specify that babies should get a shot before they leave their birth hospital. In 2018, the recommendation was revised to specify that all infants should get the shot within 24 hours of birth. Nevison failed mention this history in her presentation.

Dr. Cody Meissner, a professor of pediatrics at Dartmouth and the only current member of ACIP who has experience on the committee, said he took “strong positions against each of the three presentations.”

“This disease has gone down in the United States thanks to the effectiveness of our current immunization program,” Meissner said.

“The way I look at a neonatal birth dose is that it is a safety net.”