Liz SzaboTracy Hoeg: Voting to stop universally vaccinating newborns against hep B vaccine would "put us in line with peer countries."
Note: Which peer countries is she talking about? Taiwan began immunizing all babies on first day of life 6 years before the U.S., with huge success.
#ACIP
Tracy Hoeg of the FDA questioned why we should give a baby a blood test before vaccinating them. Says that we don't have a confirmed correlate of protection.
#ACIP
Andrew Johnson of CMS says the proposed voting language would not prevent babies who get federally provided insurance from being covered with no out of pocket costs.
#ACIP
Meissner. The recommendation is that after a series of 3 doses, if a person who has a blood level of this amount, that person is reliably protected against hep B. There has not been a documented case of anyone developing hep B if you achieve this titer.
#ACIP
Meissner: We know antibodies will decline over time but there will be an immune response to a booster in someone who responded and is otherwise healthy. #ACIP
Meissner: "The fact that hepatitis has not occured in someone who has received the Hep B series is about the best proof you're going to get that the vaccine is effective."
#ACIP
Milhoan: Says he was taught in medical school in 1992 that we vaccinate infants against hep B to provide herd immunity.
Note: Doctors tell me that is not true. They say we are trying to save that baby's life and prevent liver cancer, cirrhosis and liver transplants.
#ACIP
Meissner responds to Milhoan. I think we are confusing what we know and what we don't know. A titer of 10 million internationall units within 3 mos after the 3rd dose is sufficient. But is that same titer after a single dose sufficient?
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Meissner responds to Milhoan's questions.
"The harm is not giving three doses. The harm is not giving three doses as prescribed."
#Acip
Adam Langer from the CDC's hepatitis center:
25% of infants who receive 1st dose have protective titer.
But we would be making a really huge assumption that one dose that just happened to get the baby's titer up above 10 is lifetime protective.
#ACIP
Adam Langer: The U.S. is a unique country. Denmark has 6 million people. The population of NYC is 8 million. In Denmark, 95% of pregnant women are screened for hep B. That rate in US is lower. In Denmark, health care for citizens and immigrants is fee.
#ACIP
Malone: Claims "We face the dilemma of inadequate data." Is he talking about evidence for this new blood test he's proposing? Or for hep B vaccine in general?
#ACIP
Malone says "we are torn" by two conflicting points of view between doing the best thing for the most number of people and making individual decisions. "It reflects a fundamental, frankly philosophical disagreement about the role of public helath in medical practice."
#ACIP
CDC's Adam Langer: "CDC recommendations are our best recommendations at the policy level or at the population level for the entire country. It's simply not possible for us to look at every single individual case and make a decision about what's best for that particular baby"
#ACIP
Langer: "We're saying that at the population level, in the majority of cases, this is what the science shows."
#ACIP
Hibbeln just pleaded to respond to Malone.
Malone rasied his voice ad pointed his finger to cut him off, speak over him. HIbbeln protested that Malone let other people talk. Malone spoke over Hibbeln
"No, no, I'm sorry, I'm sorry. You're on the queue. You're on the queue."
#acip
Levi: "I don't know what the outcomes of this vote will be. I know what I'm going to vote."
#ACIP
Meissner. Sighs. "First of all there's no question that parents have the key decision making in the administration of vaccines but society also has to make recommendations in terms of an infant who is too young to make decisions for himself or herself."
#ACIP
Meissner. "What we're doing is making a recommendation based on what we know and what we don't know. And we know that three doses given to the existing schedule are safe and are effective in preventing hepatitis B."
#ACIP
Hibbeln: Milhoans' comments that babies are different from adults and their blood/brain barrier and immune system. "But it's completely still a hypothesis that this impacts whether a dose should be given before or after 3 months."
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Blackburn. "I know many parents who have been dismissed from pediatric practices practices for wanting to discuss timing or spacing out of vaccines."
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Amy Middleman, the representative for the Society for Adolescent Health and Medicine. "As a hep B researcher, there has been a lot of misinformation" over the past two days and even misinterpretation of her own study. Malone cuts her off and says her time is up.
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Middleman: Lot of misinformatoin at #AICP. "It would take a long time to go through it. One example is the surveillance system that comprises the graph about acute hepatitis B cases ... There was a misinterpretation of the my own study."
Dr. Goldman of ACP: "I agree with you on the Principles of scientific inquiry and rigor that you opened the meeting with. I would just like to see this committee actually use it in practice." #acip
Goldman:(Pebsworth said stakeholders want to revisit vaccines.) "Is there is a detailed drill down of which stakeholders want to change" vaccine recommendations? "Is it the majority of the country, or is it just a small segment who oppose the birth dose on ideology and not on science?"
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Munoz of IDSA. "We, please, would like to ask for your responsible decision to dismiss this vote if you really are the best interest in the public in mind." #acip
Meissner: "I am hopeful the pediatricians will continue to administer the birth dose w/in the 1st 24 hrs after delivery and before discharge from hospital. I think to follow any other course is not in the interest of the infant, as we've repeatedly said. There is no evidence of harm." #acip
Hibbeln took issue with wording "parents should consult with health care providers." #acip
"This places the onus on the parents to approach the health care provider and presumes that the parent actually has a complex has an understanding of a very complex and difficult practice management problem."